Now the targeted therapeutic drugs have become the hottest field in many kinds of cancer and appear to have the advantages of low toxicity and high efficiency. There are a lot of clinical trials on the efficiency and the side effects. This article focuses on the latest advances of the targeted drugs on digestive tract cancers.

Metabonomics is a novel subject which develops after genomics,transcriptomics and proteomics.With its unique advantage,metabonomics has been used widely in screening diagnostic biomarker in a variety of tumors.At present,some diagnostic biomarkers are found in tissue,serum samples,urine samples and stool specimens of gastrointestinal cancer patients by metabonomics,which maybe helpful for the early diagnosis and individualized treatment of gastrointestinal cancer.

The hereditary diffuse gastric cancer (HDGC) is associated with CDHI (E-cadherin gene)germline mutations, and accounts for about one-third of the familial gastric cancer (FGC) cases. The other two thirds FGC cases which are not fit the diagnosis standard of HDGC remain lack of clear molecular diagnosis basis. The current disposal of prophylactic gastrectomy in FGC according to E-cadherins genetic counseling, has clinical significance only in part of HDGC.

Phospholipase A2 (PLA2) is consisted of a large group of enzymes,which can hydrolyze Sn-2 ester bond of the phospholipids and have different structures and functions.According to the latest related researches,many subtypes of PLA2 express abnormally in a various of tumors and have a close relationship with cancer proliferation,apoptosis,invasion,metastasis and prognosis.Different subtypes have different effects on neoplasms.PLA2 can supply a new insight on cancer therapy.

Objective To evaluate the 7th edition American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumor node metastasis (TNM) staging system for gastric carcinoma with the 6th edition in Chinese population.Methods A total of 401 gastric cancer patients undergoing surgical resection was staged using the 6th and 7th edition AJCC TNM staging system,respectively.Homogeneity,discriminatory ability,and monotonicity of gradients of two systems were compared using linear trend x2 test,likelihood ratio x2 statistics,and akaike information criterion (AIC) calculations.To compare the accuracy of prognostic evaluation between the 6th and the 7th edition TNM staging system for gastric cancer.Results Significant difference in 5 years survival rate were observed according to the T/N classification using the 6th edition staging system,and there were similar survival curves between T1a and T1b according to the 7th T classification.There was not significant difference between the area under the curve (AUC) of the 6th and the 7th edition staging systems.Conclusions T staging and N classification according to the 7th edition showed better performance,but the 72 TNM staging system was not better in predictive accuracy.

Although great achievement has been made on the diagnosis and treatment of malignant tumors,metastasis of tumor remains to be the major reason for treatment failure and death of their victims.The development of systematic biology and functional genomics give us a deeper understanding of the nature of metastasis at the molecular level.Based on the consensus reached on the metastasis mechanisms of cancer,including the genetic heterogeneity of cancer,pre-metastatic niche,epithelial-mesenchymal transition,anoikis resistance,angiogenesis and lymphangiogenesis,etc,the targeted therapy at molecular level should be emphasized,the treatment should target the tumor stem cells,and RNAi technique and other techniques should be used in clinical anti-metastatic therapy.

This paper explored effect of AF internal fixation system in reduction of lumbar vertebral fracture.AF internal fixation system acts fixation and reduction roles for most of spinal blowout fracture through spinal hyperextension or devise opening to reduce fracture blocks in vertebral canal or anterior vertebrae.In addition,it alleviates neural compression to some extent.The collapsed vertebral reduction is achieved by traction of anterior and posterior longitudinal ligaments as well as intervertebral annulus fibrosus;the physiologic curvature and vertebral height are restored.Moreover,the spinal stability is maintained.Early functional exercise can promote fracture healing and reduce complications.In treatment of lumbar vertebral fracture by AF internal fixation system,screw entry,reduction,traction,and fusion are completed based on host biomechanics,and biocompatibility of implant and host should be paid more attention.

Objective: To study the effect of arsenic trioxide (As2O3) on human pancreatic cancer cell proliferation and apoptosis (mainly early stage) in vitro. Methods: SW1990 cells line were trea ted with As2O3 at different concentration. Cell proliferation was evaluated by MTT and apoptosis by Annexin-Ⅴ-fluostaining, electron-microscopy, flow cytometry and immunocytochemical staining of Bcl-2 and Bax. Results: As2O3 and cisplatin had the same cytotoxity on SW1990. The cytotoxic effe ct on tumor cell was produced by induction of apoptosis. Twelve hours after cult ure with 10 μg/ml As2O3, much more SW1990 cells went into apoptosis than t he control. The apoptosis rate reached 24% after 48 h with the similar concentra tion of As2O3. Immunohistochemical study revealed that the expression of Bcl -2 was decreased after treated with As2O3. Conclusion: As 2O3 can depress the proliferation of SW1990 in vitro, mainly through the i nduction of apoptosis, and it is a potential agent for pancreatic cancer chemoth erapy.

Objective To evaluate the clinical results of uncemented fully porous-coated long femoral stems in treating Vancouver type B2 periprosthetic femoral fracture following hip arthroplasty.Methods A retrospective analysis was made on 12 patients (12 hips) with Vancouver type B2 periprosthetic femoral fracture treated using the uncemented fully porous-coated long femoral stem prosthesis combined with cerclage fixation with steal-wire or titanium cable devices from February 2006 to January 2013.There were 5 males and 7 females,aged average 69.8 years (range,62 to 79 years).The status of primary arthroplasty was uncemented bipolar hemiarthroplasty in 2 patients and total hip arthroplasty in 10 patients (2 cement and 8 cementless femoral stems).At the final follow-up,Harris hip score for clinical evaluation,Beals and Tower's criteria for radiological evaluation,and complications were recorded.Results There were no intra-operative complications such as femoral perforation and femoral fracture.All patients were followed up for mean 38 months (range,24-72 months).At the last followup,mean Harris hip score was 87.2 points (range,50 to 100 points).All fractures healed at average 16 weeks (range,12-28 weeks).All the 12 hips showed prosthesis stability despite there was one femoral stem subsidence of 3 mm.One patient slipped and sustained another periprosthetic fracture (Vancouver type B1) at postoperative 4 months and was treated successfully with locking plate and cables.According to the Beals and Tower's criteria,there were 10 excellent,1 good and 1 poor results.Final follow-up revealed no complications of deep vein thrombosis,dislocation and prosthesis loosening.Conclusion Uncemented fully porous-coated long femoral stems provide good primary stability that promotes fracture healing and offers a reasonable treatment of Vancouver B2 femoral periprosthetic fracture.

Objective To investigate the clinical application of CT perfusion imaging in assessing the hemodynamic changes in patients with small hepatocellular carcinoma (<5 cm) before and after transcatheter arterial chemoembolization (TACE). Methods Twelve patients with small hepatocellular carcinoma were enrolled in this study. CT perfusion imaging of the liver was performed 1 - 2 days before and 3 - 4 weeks after TACE. By using the perfusion parameters the hemodynamics of the preoperative and postoperative tumor tissue, the hemodynamics of the preoperative tumor tissue and the normal tissue, and the hemodynamics of the postoperative active tumor tissue and the normal tissue were determined , and the results were compared between each other. Results Before TACE, the blood flow (BF), hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) and permeability of surface (PS) in the tumor tissue were significantly higher than those in the normal tissue (P < 0.01), while after TACE all the perfusion parameters except blood volume (BV) were significantly decreased in the tumor tissue (P < 0.01). After TACE, BF, PS, HAF and HAP in the activity tumor tissue were increased more than those in the normal tissue (P < 0.05). Conclusion CT perfusion imaging is of great clinical value in diagnosing < 5 cm hepatocellular carcinoma , in evaluating the hemodynamic changes after TACE and in demonstrating the activity of the residual tumor tissue.