An early and accurate response evaluation is essential for clinicians to decide whether to continue the treatment with current thera-peutic regimen or to make necessary changes.This article briefly introduces the development of response evaluation criteria for tumors,elab-orates on the application of radiological evaluation criteria in local interventional therapy or sorafenib treatment of hepatocellular carcinoma (HCC),compares the four radiological evaluation criteria,i.e.,World Health Organization (WHO)criteria,Response Evaluation Criteria in Solid Tumors (RECIST),European Association for the Study of Liver (EASL)criteria,and the modified RECIST (mRECIST),and thinks that EASL criteria and mRECIST are better than WHO criteria and RECIST and can predict the prognosis of HCC patients at earlier time points.

A methodology named immunoscorehas been proposed in recent years.It has been demonstrated to be a prognostic factor superior to the Union for International Cancer Control-American Joint Committee on Cancer (UICC-AJCC)TNMclassification.Over the past few years,it has gained a forefront posi-tion in colorectal cancer.It has the advantages of simple operation,low cost and high accuracy,and it is nee-ded for individual therapy.However,it still has its limitations.

BACKGROUND: Apart from anticoagulation property and suppressing platelet congregation capability, tongxinluo preparation has been proved by traditional Chinese medicine to possess certain function for protecting endothelial cells.OBJECTIVE: To observe the influence of Chinese medicinal herb "tongxinluo" compound on adhesion molecule expression in brain ischemia-reperfusion (IR) animal model.DESIGN: Randomized and controlled experiment.SETTING: Department of Neurology, Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA.MATERIALS: This experiment was conducted at the laboratory of the Department of Neurology, Shanghai Changzheng Hospital, between October 2002 and January 2003. Totally 25 male SD rats were randomized into sham-operation group of 5 rats, model group of 10 rats and tongxinluo group of 10 rats.METHODS: Middle cerebral artery was occluded using thread-bolt method to induce focal brain IR model in rats. In sham-operation group,nylon thread was placed around the external carotid artery approximating to the branch of internal carotid artery, and the other procedure was the same as that in model group. Rats in tongxinluo group were given tongxininfusion before IR for 1 consecutive week, which was replaced by physiological saline of the same dosage in model group and sham-operation group. Brain tissues were obtained under anesthesia condition and cut into slices; conventional HE staining, immunohistochemical and in situ hybridization staining were conducted.MAIN OUTCOME MEASURES:① The number of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)positive microvessels following IR injury.② The number of ICAM-1 and VCAM-1 mRNA positive microvessels following IR injury.RESULTS:① In sham-operation group,ICAM-1,VCAM-1 protein andICAM-1 mRNA positive microvessels could not be observed in hemispheric cortex and basal ganglion at the operative side.② In model group,the positive expression of ICAM-1, VCAM-1 protein and ICAM-1 mRNA obviously increased at the ischemic side at 6-hour reperfusion following 2-hour ischemia.③ In tongxinluo medication group,the positive protein and mRNA-expressing microvessls were found remarkably reduced in number in ischemic side hemispheric cortex and basal ganglion [(10.42 ±1.98),(12.42±2.14)/HP; (8.54±2.00), (11.12±1.56)/HP] (P ＜ 0.05), but the positive VCAM-1 protein-expressing microvessels did not change remarkably (P ＞ 0.05).CONCLUSION: Tongxinluo can suppress ICAM-1 transcription and translation following rat brain IR, thus attenuating inflammatory injury induced by brain ischemia.

Objective:To observe the quantitative and morphological changes of astrocytes in nucleus of solitary tract(NTS) after vagus nerve stimulation(VNS).Methods:Light and electron microscopy immunohistochemisty were used to examine the relationship between astrocytes and neurons by observing the expression of glial fibrillary acidic protein(GFAP),which is the specific protein for astrocytes. Results:Immunoreactivities of GFAP were significantly enhanced after VNS in NTS of rats. Meanwhile,the hypertrophy cell bodies and dark long processes could be seen under high power field. For electron microscopy,immunopositive GFAP astrocytes connected closely with the dendrites or axons of the neurons. The number of synapse increased remarkably after VNS compared with that of the control. Conclusion:Our data indicate that not only the neurons but also the astrocytes in the NTSs play a very important role in the process of the antiepileptic mechanism during VNS.

To explore the binocular disparity information for children with a normal vision based on computer-assisted evaluation system.We examined the random dot zero-order disparity,line zero-order disparity,2nd-order disparity and random dot motion parallax for 97 children with normal vision.And 94 children reached 100″ vision disparity both in random dot zero-order disparity and line zero-order disparity (pass rate of 96.9％) ; all 94 cases passed the 2nd-order disparity and random dot motion parallax.Thus children with a normal vision develop their stereopsis.

Objective To prevent the medical personnel from infection during aeromedical evacuation of fulminating respiratory infectious disease patients by exploring the changes of differential pressure between those in and out of the negative-pressure isolation capsule and analyzing the stability of the capsule during aeromedical evacuation.Methods A differential pressure monitor developed by Institute of Medical Equipment was used for real-time recording of the changes the differential pressure in and out of the capsule during five flight phases of the aircraft,and the safety of the capsule during aeromedical evacuation and corresponding considerations were investigated.Results The maximum and minimum values of the negative pressure in the capsule were-60 Pa and-120 Pa respectively during aeromedical evacuation,which were all less than the safety threshold-15 Pa.The negative pressure was is directly proportional to the flying altitude.Conclusion The capsule keeps negative pressure effectively during flight,and thus facilitates patient aeromedial evacuation greatly.

Objective To investigate the effect of elevating the root of tongue bare-handed to assist ProSeal laryngeal mask airway insertion in patients with tongue body hypertrophy under general anesthesia. Methods Sixty ASAⅠ~Ⅲgrade patients with tongue body hypertrophy undergoing surgery in general anesthesia were randomly divided into two groups:30 cases in each group. After anesthesia induction ,laryngeal mask airway was inserted in the observation group with assistance of elevating the root of tongue bared-handed ,while inserted in the control group by standard method.Insertion time ,success rate of the first and secondary and total insertion ,pharyngolaryneal complications at 24 hours after removal were recorded ,as well as the success rate of gastric tube intubation was recorded. Results Compared with the control group ,insertion time was significantly shortened (P < 0.05). Success rate of the first and total insertion were increased (P < 0.05).Success rate of gastric tube intubation was increased(P < 0.05),and pharyngolaryneal complications were decreased (P < 0.05) in the observation group. Conclusions Elevating the root of tongue bare-handed to assist ProSeal laryngeal mask airway insertion in patients with tongue body hypertrophy is a simple and fast method with high success rate ,good apposition and less complications. Its efficacy is better than that of the standard method.

Objective To determine the effect of inhaling rosemary compound essential oil on learning and memory and the expression of choline acetyl transferase (ChAT) in the CA1 region of the hippocampus in rats with vascular dementia (VD).Methods A modified 2-VO method was used to induce permanent brain hypoperfusion,and thus VD,in 60 male SD rats aged 2 months.They were then randomly divided into a normal control group (n =10),a sham-operation group (n =10),a model group (n =10),a rosemary compound essential oil group (n =10) and an edaravone group (n =10).The rosemary compound essential oil group inhaled a compound of the essential oils of rosemary,eugenol and peppermint once a day; the edaravone group was given a daily injection of edaravone injecta.Both the interventions lasted for 65 days.A water maze was used to test their learning and memory abilities.Morphological damage in the CA1 region of the hippocampus and the expression of ChAT were also observed.Results The learning and memory abilities of the model group were significantly weaker compared with the sham-operated group and the normal controls.The rats in the rosemary compound essential oil and edaravone groups were obviously better than those in the model group,but there was no significant difference between rosemary compound essential oil group and the edaravone group.The morphological damage observed in the hippocampus and striatum of the model group was significantly greater,on average,than that observed in the rosemary compound essential oil group and the edaravone group.The average number of ChAT positive units in the CA1 region of the hippocampus was significantly greater in both the rosemary compound essential oil group and the edaravone group compared with the model group,but there was no significant difference between the rosemary compound essential oil group and the edaravone group.Conclusions Inhaling rosemary compound essential oil can improve the learning and memory abilities of rats with VD caused by permanent chronic brain hypoperfusion.It decreases the damage to the neurons of the hippocampus,increases the expression of ChAT,and shows a therapeutic effect on VD,at least in rats.

Objective To analyze the economic effects of different rehabilitation patterns for children suffering from cerebral palsy. Methods A total of 153 cerebral palsy patients were divided into a hospital-community-family rehabilitation group(n = 52), a hospital rehabilitation group (n = 50) and a non-intervention control group (n = 51). Those in the first group were provided with a hospital-community-family rehabilitation therapy pattern, those in the sec-ond only hospital rehabilitation and the third no intervention. All the patients were evaluated using the Gross Motor Function Measure-88 (GMFM-88) Scale and the Cost Measure Scale at admission, and at the end of the 3rd and 6th months of treatment. Results There were no significant differences in gross motor function among the three groups at admission. At the end of the 3rd month and the 6th month there were significant differences between the children in the hospital-community-family rehabilitation program and those in the hospital rehabilitation program in terms of gross motor function. Their general percentage, monthly percentage and monthly relative percentage results were all significantly different. But there was no significant difference in the non-interventian control group since admission. Every unit of improvement in gross motor function cost $101.87±97.59, $75.11±45.75 in the hospital-community-family reha-bilitation program and $387.21±54.76, $170.31±123.16 in the hospital rehabilitation program at the end of the 3rd and the 6th month respectively. So the cost of the former was only about 30% of the latter. Conclusion Hospital rehabilitation is suitable for the early rehabilitation of cerebral palsy children. Hospital-community-family rehabilitation is better for long-term rehabilitation of cerebral palsy children, and what is more, it can decrease the rehabilitation ther-apy cost substantially. So a hospital-community-family rehabilitation pattern is more compatible with China's national situation.

AIM: To investigate the effects of sodium hydrosulfide ( NaHS ) , a donor of hydrogen sulfide ( H2 S) , on the membrane permeability , intracellular Ca 2+concentration ( [ Ca2+] i ) and the release of IL-1βinduced by a-denosine triphosphate (ATP) in rat microglia, and to explore the effect of H2S on ATP-P2X purinergic signaling pathway and the molecular mechanism of its neuroprotective effect .METHODS: Rat microglia in logarithmic growth phase were used in the study.The [Ca2+]i was detected by Fura-2/AM staining.Fluorescent dye YO-PRO-1 was used to observe the membrane permeability.Interleukin-1β(IL-1β) was measured by rat IL-1βELISA kits.RESULTS:The YO-PRO-1 flu-orescence intensity was obviously elevated by ATP induction in a dose -dependent manner in the rat microglia , but this effect was counteracted by NaHS pretreatment (P<0.05).[Ca2+]i rapidly increased and then decreased slowly , forming a sta-ble platform for a long time when rat microglia were treated with ATP .Ca2+spike activity induced by ATP had no change , but the platform disappeared (P<0.05) after NaHS pretreatment.The ATP and LPS together facilitated the release of IL-1β, but the phenomenon was inhibited by NaHS (P<0.05).CONCLUSION:Hydrogen sulfide may decrease the mem-brane permeability , calcium inflow and IL-1βrelease in rat microglia activated by high dose of ATP .The cytoprotection of hydrogen sulfide may be mediated by purinergic signaling pathway .