Objective: To evaluate the therapeutic effect of transarterial chemoembolization (TACE) combined with apatinib on pa-tients with advanced hepatocellular carcinoma (HCC). Methods:Twenty-one patients were treated with TACE combined with 250 mg of apatinib once a day. Disease classification was assessed by investigators using the modified Response Evaluation Criteria in Solid Tu-mors (mRECIST). The evaluation period was 28 days. Results:The therapeutic effects were classified as follows:3 patients (14.3%) had complete response, 6 patients (28.6%) had partial response, 5 patients (23.8%) had stable disease, and 2 patients (9.5%) had progres-sive disease. The disease control rate was 61.9%, and the objective response rate was 38.1%. In patients, the most frequent adverse events were fatigue (94.4%), anorexia (23.8%), diarrhea (19.0%), hypertension (19.0%), and hand-foot syndrome (19.0%). Conclusion:The short-term therapeutic effect revealed that the combination of TACE and apatinib could be a promising treatment for patients with advanced HCC. Adverse events should be closely monitored and provided with active management.

Objective:To evaluate the clinical efficacy and safety of caffeic acid for thrombocytopenia induced by cancer chemothera-py. Methods:A total of 60 patients received the same chemotherapy treatment on cycles 1, 2, and 3. They were given mimetic agent as negative control on the first course. On the second and third cycles, caffeic acid tablets were given from the first day of chemothera-py. Results:The lowest and highest platelet levels of the treatment group during the drug treatment period were significantly higher than those of the negative control group (P<0.001). No significant difference in the period of days of PLT<50×109/L was observed be-tween the groups, although a decreasing trend (P>0.05) was observed. After chemotherapy, the days required for platelet recovery to PLT≥75×109/L and PLT≥100×109/L in the treatment group was significantly fewer than in the negative control group (P<0.001). All the patients did not receive any platelet transfusion during the trial. Conclusion:Caffeic acid tablets were safe and effective for thrombocy-topenia induced by tumor chemotherapy.

Objective:To analyze the pathogenesis, clinicopathological characteristics, diagnosis, and treatment of the malakoplakia for the purpose of avoiding misdiagnosis and missed diagnosis. Methods:Clinicopathological features of four malakoplakia patients admit-ted to the Shanxi Cancer Hospital from March 2007 to March 2017 were studied by light microscopy, immunohistochemistry, and spe-cific stain technology, combining with a review of literature. Results:The onset age of the 4 patients (two males and two females) ranged 56-76 years (median:63 years). Two patients had malakoplakia in bladder;one patient had malakoplakia in bilateral ureters;and one case had malakoplakia in right pelvic. One patient has a history of systematic lupus erythematosis and diabetes. Malakoplakia is characterized by the accumulation of foam cells and concentrically-layered basophilic inclusions called Michaelis-Gutmann (M-G) bodies. The foam cells were positive for CD68 and PGM-1 by immunohistochemistry, indicating its derivation from the histocyte. M-G bodies were positive for periodic acid-Schiff reaction, iron, and calcium by specific staining technology. Conclusion:Malakoplakia is a rare inflammatory condition and a common urinary tract disease, but it may involve any organ with non-specific symptoms and can form tumor-like nodules that clinically simulate malignancy in various organs. Clinicopathological features can be used as diagnostic markers in malakoplakia diagnosis through specific stain technology.

Objective:For cancer patients who underwent extensive surgery, drastic release of myoglobin (Mb) after surgery can cause hypermyoglobinemia and related problems. This retrospective cohort study aims to summarize our experience and outcomes of 60 pa-tients with hypermyoglobinemia after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), to investi-gate the changes in postoperative Mb levels, and to explore the clinical value of Mb. Methods:This retrospective study covered 60 pa-tients with peritoneal carcinomatosis who were treated with CRS and HIPEC. All patients developed hypermyoglobinemia after opera-tion. Immediately after CRS and HIPEC, the patients were placed in a comprehensive treatment regimen consisting of hemodynamic stabilization therapies, nutritional support, anti-sepsis therapies, and psycho-physical therapies. For the treatment of hypermyoglo-binemia, intravenous injection of sodium bicarbonate solution according to the Mb level was given to the patients. Moreover, the pre-and post-operative concentrations of Mb, blood urea nitrogen (BUN), and creatinine (Cr) were evaluated. Results:Serum Mb levels af-ter CRS and HIPEC were significantly elevated and peaked on the surgery day. Prompt treatment with intravenous infusion of sodium bicarbonate solution could help decrease the serum Mb levels and alleviate potential damage. Serum Mb levels returned to normal in approximately 3-4 days. The serum BUN levels increased after operation and peaked on the fourth postoperative day. On the other hand, serum Cr levels increased 2 days after operation and began to decrease on the third postoperative day. One patient developed renal failure and sepsis and died on postoperative day 26. The other patients recovered from the surgery without major adverse events. Conclusion:Hypermyoglobinemia is a common lab abnormality after CRS and HIPEC, and serum Mb levels could be an early and sensitive indicator for dramatic disturbances in the internal milieu after surgery. Adequate treatment with sodium bicarbonate could accelerate the reduction in serum Mb levels and reduce the risk for major organ damages.

To evaluate the reliability and accuracy of MRI-guided stereotactic biopsy for supratentorial brain lesions. Method: A total of 103 cases of MRI-guided biopsy were performed between November 2009 and December 2013. Patients' pathological results and postoperative rehabilitation courses were analyzed. Results: A total of 102 patients (99.0%) had pathological results, of which 97 cases were brain tumors (86.0%), including 36 cases of astrocytoma, 9 cases of anaplastic astrocytoma, 10 cases of oligoastrocytoma, 4 cases of anaplastic oligoastrocytoma, 4 cases of anaplastic ligodendroglioma, 3 cases of glioblastoma multiforme, 27 cases of lymphoma, 3 cases of germcell tumors, and 1 case of rhabdomyosarcoma. Inflammatory lesions were found in 3 cases (2.9%). Displacement of brain gray matter was reported in 2 cases (2.0%), and 1 case (1.0%) of cerebral infarction existed. A total of 3 patients suffered intracranial hematoma after biopsy, and 1 patient underwent craniotomy to remove the hematoma. No death or intracranial inflammation occurred after biopsy.Conclusion: MRI-guided stereotactic biopsy is a safe and reliable method in qualitative diagnosis. It is a very important tool for diagnosis and treatment selection for intracranial lesions.

Objective:This study aims to evaluate the correlation of combined preoperative plasma levels of fibrinogen (Fbg) and lym-phocyte to monocyte ratio (LMR) (F-LMR) with the prognosis of patients with non-small cell lung cancer (NSCLC) after complete resec-tion. Methods:The clinical data of 589 patients with NSCLC who underwent complete resection in our hospital were retrospectively analyzed. Receiver operating characteristic curve (ROC) analysis was used to select the cut-off values of Fbg and LMR. Based on the cri-teria of F-LMR, we divided the patients into three groups:F-LMR 0 score, F-LMR 1 score, and F-LMR 2 score. The association between F-LMR and the clinicopathological characteristics was analyzed by theχ2 test. Kaplan-Meier analysis was used to analyze the prognostic factors, and the log-rank test was used to determine the differences in survival rates. Prognostic factors were assessed by univariate and multivariate analyses (Cox's proportional hazards regression model). Results:According to the ROC curve, the cut-off values of Fbg and LMR were 3.48 g/L and 3.23, respectively. F-LMR 0 score had n=215, F-LMR 1 score had n=228, and F-LMR 2 score had n=146. Pre-operative F-LMR was closely related to age, gender, smoking history, tumor location, surgical type, pathological stage, pathological type, and tumor size (P<0.05). Univariate analysis showed that tumor location, surgical type, pathological stage, tumor size, F-LMR score, LMR, and Fbg were associated with survival (P<0.05). Multivariate analysis showed that the pathological stage [disease-free sur-vival (DFS): hazard ratio (HR)=1.700, 95%confidence interval (CI)=1.483-1.950, P<0.001;overall survival (OS):HR=1.703, 95%CI=1.486-1.952, P<0.001] and F-LMR score (DFS:HR=1.264, 95%CI=1.077-1.484, P=0.004;OS:HR=1.301, 95%CI=1.107-1.528, P=0.001) were the independent prognostic factors of NSCLC patients. Conclusion:The preoperative F-LMR score may be a useful blood marker for predicting the prognosis of patients with NSCLC with radical resection.

Objective:To investigate the prognostic significance of high sensitivity-C reactive protein (Hs-CRP) in patients with peripher-al T-cell lymphoma (PTCL). Methods:A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retro-spectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index (IPI), were determined. Af-ter a median follow-up of 23 months, the relationship between Hs-CRP and overall survival (OS) was observed. Results:Serum Hs-CRP level positively correlated with IPI score (r=0.132, P<0.001), tumor stage (r=0.183, P=0.005), B symptoms (r=0.225, P=0.001), and lactic dehydrogenase (r=0.169, P=0.009), but negatively correlated with plasma albumin levels (r=?0.343, P<0.001), hemoglobin concentra-tion (r=?0.239, P<0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion:The baseline Hs-CRP level can serve as a major indicator of prognosis in PT-CL patients.

Objective:To investigate the pro-apoptotic effect of berberine (Ber) on human lung adenocarcinoma PC-9 cell line, and to detect the role of c-Jun N-terminal kinase (JNK)/forkhead box protein O3 (FOXO3) signaling in this process. Methods:The PC-9 cells were randomly divided into the control group and the Ber group, which was treated with 30 and 60μM Ber. The survival rate, apoptot-ic rate, ROS generation, caspase-3 activity, and mitochondrial membrane potential of cells were detected. Western blot was per-formed to detect the expression of JNK/FOXO3 signaling and apoptosis-related proteins. A JNK-specific activation inhibitor, SP600125, was used to block the phosphorylation of FOXO3 in PC-9 cells, and then treated with Ber (30 and 60μM) for further detection after 24 h. Results:Ber treatment resulted in an obvious reduction in cell viability, promotion of cell apoptosis, downregulation of mitochondri-al membrane potential, and an increase of ROS and caspase-3 in a dose-dependent manner. Western blot analysis demonstrated that Ber treatment resulted in a significant upregulation of p-JNK, FOXO3, and Bax expression, and a downregulation of p-FOXO3 and Bcl2 levels. Moreover, the inhibition of JNK activation by SP600125 antagonized the anti-FOXO3 phosphorylation role and the pro-apoptotic role of Ber on PC-9 cells. Conclusion:Ber treatment effectively inhibits the viability of PC-9 cells and enhances apoptosis and oxidative stress injury, which may be related to the upregulation of p-JNK and FOXO3 and the downregulation of p-FOXO3.

Objective:This study aims to explore the anticancer effects and potential mechanisms of HJC0152, a novel STAT3 inhibitor, on the invasion and migration capacities of human head and neck squamous cell carcinoma (HNSCC) cell lines in vitro. Methods:Cells were divided into two groups, the dimethyl sulfoxide (DMSO) group and the HJC0152 group in which HNSCC cell lines UM-1 and SCC-15 were treated with DMSO or HJC0152 for 24 h. The total expression levels of STAT3, p-STAT3 (Tyr705/Ser727), MMP-2/9, N/E-cadherin, TWIST1, and vimentin;and the cytoplasm and nuclear expression levels of STAT3 and p-STAT3 (Tyr705/Ser727) were detected by Western blot assay. Wound healing and Transwell assays were employed to detect the invasion and migration abilities of the UM-1 and SCC-15 cells. The expression and location of N/E-cadherin were visualized by immunofluorescence staining. Results:Western blot indicated that the total expression of p-STAT3 (Tyr705), MMP-2/9, N-cadherin, TWIST1, and vimentin were significantly declined and that E-cadherin was remarkably elevated in the HJC0152 group cells compared with that of the DMSO group, with no difference in STAT3 or p-STAT3 (Ser727). Cytoplasm and nuclear STAT3 (Tyr705) were also inhibited by HJC0152. Wound healing and Transwel assays indicated that tumor invasion and migration capacities were impressively attenuated in the HJC0152 group cells compared to that of the DMSO group. Conclusion:HJC0152 suppresses the phosphorylation of STAT3 at Tyr705 in the HNSCC cell lines, leading to impair transcription activity, deplete expression levels of target genes, and subsequently inhibit migration and invasion capabilities of HNSCC.

Peritoneal metastasis is very common in colorectal cancer and often indicates bad prognosis. The peritoneum, which con-tains an abundant supply of blood and specific types of resident and migrating cells, lines the surface of the abdominal wall and covers the abdominal organs. The combination of cells, extracellular matrix, and local unique physicochemical composition of the abdominal cavity provide a complex and relatively stable peritoneal microenvironment. The cells in this environment can be induced by cancer cells to be involved in tumor growth, invasion, and peritoneal metastasis. This review summarizes the major cellular components in-volved in the peritoneal microenvironment.