Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China because of high incidence of hepatitis B virus (HBV) infection.HCC is diagnosed at a late stage in most of the cases; therefore the prognosis of patients with HCC is generally poor.Early diagnosis and surgical treatment are of great clinical desirable to improve prognosis of HCC.Tumor marker is an effective means for early diagnosis,prognosis assessment and recurrence monitoring.In addition to alpha fetoprotein (AFP),Lens culinaris agglutinin-reactive AFP (AFP-L3),des-γ-carboxy prothrombin (DCP),glypican-3,N-glycome markers,candidate-susceptibility genes,microRNAs and several other biomarkers have been revealed as potential HCC markers and will be applied in clinical laboratory gradually.In this review,the efficacies of novel HCC markers and their possible implications for clinical application are described.

Primary liver cancer (PLC) is the second leading cause of cancer death in China,and is one of the most serious threats to people's health.Early diagnosis and treatment can significantly improve the prognosis of PLC.Abnormal glycosylation is reported to be closely related to the genesis and development of malignant tumors.With the advent of modern proteomic and glycomic methodologies,several alterations in fucosylation,sialylation,and glycan branching have been observed in serum of patients with PLC.Altered glycosylation profiles,glycosyltransferases and glycosylated proteins could be screened and used as potential serum markers for early diagnosis,progression monitoring and prognosis evaluation of PLC.

Objective To investigate the therapeutic effects of melatonin (MT) on human pancreatic cancer in Balb/c nude mice subcutaneous xenograft model. Methods Pancreatic cancer model was established high dose MT(20 mg· kg -1 · d-1 ) , gemcitabine( GEM,50 mg· kg -1 · d-1 ) and high dose MT combination with GEM. Tumor size was measured regularly. The tumor growth curve was drawn. The activity of mice spleen natural killer cell was determined by MTT. Results Compared with the controls [ ( 1. 476 ± 0.075) cm3 ], tumor volumes in low dose MT group[ (0.998 ±0.112)cm3], high dose MT group[ (0.756 ±0.128) cm3], GEM group [ (0. 746 ± 0. 115 ) cm3 ], combination group [ (0. 305 ± 0. 111 ) cm3 ] were significantly decreased ( P <0.01), and the tumor size in high dose MT group was smaller than that in low dose MT group, while the tumor size in combination group was the smallest. The activity of mice spleen natural killer cell was ( 18.07 ± 1.23) %in control group, and they were (44.27 ±3.19)% ,(45.16 ±3.20)% and (30.29 ±2.91)% in low dose MT group, high dose MT group, combination group, which were significantly higher than those in the control group;the activity of natural killer cell in GEM group was ( 14.24 ± 2.70) %, which was significantly lower than that in the control group (P <0.05), but the activity of natural killer cell in combination group was significantly higher than that in the GEM group (P < 0.01 ). Conclusions MT could improve the immune function of mice,inhibit the growth of tumor, and MT combination with GEM may have more potent antitumor effect.

Objective:To analyze the prognostic factors in patients with metastatic breast cancer (MBC). Methods:A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute&Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results: The median overall survival of the patients was 32 months (1 month to 132 months). Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months (4 months to 132 months), 32 months (7 months to 122 months), 29 months (1 month to 85 months), and 24 months (1 month to 98 months), respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion:Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.

Objective To figure out clinical characteristics and risk factors of secondary fungal infection in patients with chronic obstructive pulmonary disease(COPD).Methods Two hundred and ninetysix patients with COPD were enrolled in our study who were treated in the People's Hospital of Liaocheng.Of whom,56 cases with secondary fungal infection were served as infection group and other 240 cases were non infection group.The clinical data including sorts of antibiotics,the therapy periods of antibiotic,hormones,hypoalbuminemia,invasive operation and death cases were recorded.Sort of fungal were determined by sputum culture.Results Mortality of infection group was 16.1％ (9/56),obviously higher than that of the noninfected group (6.2％ (15/240)) and the difference was significant(x2 =6.436,P ＜0.05).The average sorts of antibiotic,the therapy periods of antibiotic,rate of hormones,the rate of hypoalbuminemia,rate of were invasive operation in infection group were (2.6 ±0.8),(15.4 ±2.6) d,41.1％ (23/56),57.5％ (32/56),35.7％ (20/56),higher than those in non infection group(1.6 ±0.6,(9.6 ±2.2) d,8.3％ (20/240),12.1％ (29/240),5.4％ (13/240) ; P ＜ 0.05).The total efficacy rate in non infection group was 90.4％ (217/240),higher than that in infection group (78.6％ (44/56)),and the difference was significant (x2 =4.248,P ＜ 0.05).The majority sort of fungal in infection group was monilia albicans.Conclusion The main risk factors of secondary fungal infection in patients with COPD include long-term using high-end application antibiotics,hormones,hypealbuminemia and invasive operation.The therapy on fungi is focused on pathogen treatment such as anti-fungal drug therapy.

The relationship between M3 cholinergic receptor agonist (carbachol) hyperstimulation-induced pancreatic acinar cellular injury and trypsinogen activation or NF-kappaB activation in rats was studied in vitro. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, the active protease inhibitor (pefabloc), and NF-kappaB inhibitor (PDTC) in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar cells. The results showed that as compared with control group, 10(-3) mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells (P < 0.01) following the treatment with a high concentration of carbachol (10(-3) mol/L) in vitro. The addition of 10(-2) mol/L PDTC didn't result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol (10(-3) mol/L) in vitro (P > 0.05). It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-kappaB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.
Carbachol/*pharmacology ; Cholinergic Agonists/pharmacology ; NF-kappa B/*metabolism ; Pancreas/metabolism ; Pancreas/*pathology ; Rats, Wistar ; Receptor, Muscarinic M3/agonists ; Trypsinogen/*metabolism

ObjectiveTo evaluate the clinical efficacy and toxicity of gefitinib combined with Zhenqi Fuzheng capsule in treatment of senile non-small-cell lung cancer (NSCLC) at the middle and late stages. Methods88 patients with NSCLC at Ⅲ b-Ⅳ were randomly divided into combined drugs group ( gefitinib combined Zhenqi Fuzheng capsule,n =46 cases) and single drug group (gefitinib,n=42 cases).After treatment for 60 d,the short-term efficacy,side effects and quality of life were observed and evaluated. The objective response and survival rate were assessed after following up for 2 years. Results The short-term efficacy rate in the combined drugs group (19.6 ％ ) was higher than single drug group (11.9 ％ ),but there was no significant difference between the two groups (x2=0.096,P＞0.05).The rate of Karnofsky score in improvement and stableness was 71.7％ in combined drugs group and 50.0％ in single drug group,and quality of life improved after combined drugs compared with single drug treatment (x2 =4.376,P＜0.05).The adverse effects in combined drugs group was some lower than in single drug group with no statistical significance.There was no differences in the survival rates of 2 years between the two groups(x2 =0.556,P＞0.05). ConclusionsThe gefitinib combined Zhenqi Fuzheng capsule in treatment of middle-and late-stage NSCLC is worthy to be popularized due to positive efficacy,less side effects and higher quality of life.

Objective To evaluate the clinical significance of quantitative sensory testing (QST) in screening diabetic peripheral neuropathy of the early stage. Methods One hundred patients with type 2 diabetes mellitus were examined by nerve conduction velocity (NCV) and QST examination. With the NCV positive as the gold criterion for screening diabetic peripheral neuropathy of the early stage, the sensitivity and specificity of QST was further analyzed for diagnosis of the early stage diabetic peripheral neuropathy. Results Among the 100 patients with type 2 diabetes mellitus,there were 41 cases positive and 59 cases negative in NCV examination. On the other hand,there were 74 cases positive,and 26 cases negative in QST. The sensitivity and specificity of QST for the diagnosis of early stage diabetic peripheral neuropathy was 97.56% (40/41) and 42.37% (25/59). Conclusions In the screening of early stage diabetic peripheral neuropathy,QST shows higher detection sensitivity,but lower specificity than NCV examination. Therefore, QST may be an examination for the supplement of the routine electromyography.

0.05).The infiltration of tumor to the muscularis mucosa or serosa layers was significantly correlated with the risk of GISTs(?~2=4.87,P

Objective To study the correlation between preoperative dye exclusion test and liver function in patients with primary hepatic carcinoma.Methods This was a cross sectional survey.A total of 192 cases of primary liver cancer patients were recruited from May 2014 to March 2015 at the Second Military Medical University Affiliated Eastern Hepatobiliary Surgery Hospital.Hereinto, 160 cases were male and 32 females, the male to female ratio was 5: 1.The age of the patients ranged from 26 to 72 years old, and the average age was 50.5 years old.ICG 15 minutes retention rate of ICG clearance test was determined by PDD method in 192 cases of primary liver cancer patients.ICGR15 value was stratified into three stages: ICGR15 ＜ 10％ , ICGR1510％-20％ , and ICGR15 ＞ 20％.The ICGR15 stage of patients with different ChildPugh grades was analyzed.The biological liver function indexes of patients were simultaneous detected including TBIL, TBA, TP, ALB, PA, ALT, AST, PT-INR, HA, LN, Ⅲ, Ⅳ, APRI, PLT etc.The correlations of ICGR15 and biological indexes of liver function were analyzed using Spearman nonparametric correlation analysis.Results (1) ICGR15 was positively correlated with Child-Pugh grade (r =0.477, P ＜ 0.01) in the 192 cases of HCC.The hierarchical analysis showed that there were significant differences between ICGR15 and different Child-Pugh grades (P ＜ O.05).(2) Child-Pugh classification and ICGR15 comparison further showed that, ICGR15 increased with Child-Pugh grade.While ICG plasma clearance rate (ICGK) and effective hepatic blood flow (EHBF) reduced (P ＜ 0.05).(3) The correlation analysis between ICGR15 and biological indexes of liver function showed that: ICGR15 was positively correlated with TBIL,TBA, ALT, AST, AFU, GGT, PT-INR, HA, LN, Ⅲ, Ⅳ and APRI index [(AST/ULN) × 100/ PLT (× 109/L)] (r =0.422, 0.389, 0.219, 0.301, 0.219, 0.244, 0.325, 0.652,0.403, 0.523, 0.519, 0.434, P ＜ 0.05);and was negatively correlated with TP, ALB, PA, SOD, WBC, PLT (r =-0.290,-0.532, 0.546, 0.531, 0.256, 0.327, P＜ 0.05).Conclusions ICGR15 as a indicator for liver reserved and dynamic function can comprehensively reflect the liver reserve function is associated with the existing Child-Pugh grades and liver function biochemical indexes.Therefore, ICGR15 could be served as a sensitive index reflecting the preoperative liver reserve function.