Scientific research of clinical disciplines has its own characteristics and requirements, in which the directions and topic selection are an essential step.This article introduces the author's experience in determining the directions and topics of clinical disciplinary research from the aspects of its practicality, advancement, innovativeness, feasibility and comprehensiveness, and some methods for cultivating medical graduates' ability of topic selection in clinical disciplinary research.

Objective:To select an appropriate dosage of IL-2 for tumor infiltrating lymphocyte(TIL).Methods:Isolated by the attachment method we established,TIL was cultivated in self-supernatant of malignant pleura,with three different concentrations of IL-2,such as 6000u per ml,6000u per ml for the first administration followed by 1000u per ml,or 1000u per ml.The expansion,killing activity and phenotype changes of TIL cultured in different cultures were assessed.Results:As cultured in self-supernatant of malignant pleura fluid,the concentrations of IL-2,such as 6000u per ml or 6000u per ml for the first administration followed by 1000u per ml seemed benefit for TIL proliferation.Conclusion:6000u per ml of IL-2 for the first administration was very important.It could help TIL to activate and proliferate early.The study described here offers the possibility for TIL cultured in vitro self-supernatant of malignant pleura fluid in vitro for a short time,and then reinfuse to thorax for further expanding and controlling the malignant pleura effusion in the presence of IL-2,and thereby minimizing the risks of contamination.

Objective:To study the effect of autologous supernatant of malignant pleura effusion and RPMI1640 with 10% AB+ serum on the culture of tumor infiltrating lymphocytes (TIL) in vitro. Methods:Isolated by the attachment method we established, TIL was cultured in either autologous supernatant of malignant pleura fluid or RPMI1640 with 10% AB+ serum, and various types of cytokines such as (IL-2,) PHA and antibody against CD3 (OKT3) were added into both cultures. The proliferation as well as the killing activity and the phenotype changes of TIL cultured in the two kinds of cultures were compared. Results:There was no difference in the proliferation or the killing activity in vitro as well as the phenotype changes of TIL between the two kinds of cultures. Conclusion: Autologous supernatant of malignant pleura fluid could be used as TIL culture medium. The method described here made it possible for TIL to be cultured in vitro for a short time, and then reinfused back to thorax for further expanding and controlling the malignant pleura effusion in the presence of IL-2, and it alsominimized the risks of contamination.

CyberKnife is a newly developed technology in the field of stereotactic radiosurgery/radiotherapy(SRS/SRT).Compared with conventional SRS/SRT,there are many advantages for CyberKnife in terms of being real-time image-guided,frameless,highly accurate,etc.Recently,it has been used to treat different types of malignant carcinoma including intracranial and extracranial tumors.This article summarized the contemporary progress of CyberKnife in the treatment of intracranial and extracranial tumors.

Inhalation chemotherapy and immunotherapy is a developed technique for respiratory neoplasm recently. It is easy manipulated with high local response and little side effects. The drugs include 5 FU,DDP, taxol, camptothecin,interleukin 2 and GM CSF, etc. Inhalation chemotherapy and immunotherapy have been successfully applied for the therapy of primary lung cancer as well as the lung metastases other tumor.

Background and purpose:Mir-21 has been demonstrated high expressed in many kinds of tumor tissues and cell lines. High expressed miR-21 leads to chemoresistance. Circulating miRNA is a novel biomarker for chemosensitivity prediction. The aim of our study was to investigate the role of plasma and tumor miR-21 levels as predictive biomarkers for irinotecan in gastric cancer. Methods: The histoculture drug response assay (HDRA) was used to determine irinotecan and cisplatin sensitivity on 35 freshly removed gastric tumor specimens. miR-21 expressions in tumor and plasma were determined by quantitative reverse transcription polymerase chain reaction. Results:Plasma miR-21 was closely correlated with corresponding miR-21 mRNA level in tumor tissues (rho=0.736, P<0.001) and was not correlated with sex, age, pathology type, differentiation, lymph node metastasis, TNM stage or tumor location. Patients with stage Ⅱ-Ⅲhad higher miR-21 levels. The tumor miR-21 expressions in cisplatin-sensitive group and resistant group were 1.32 (95%CI:0.73-1.90) and 4.06 (95%CI:1.71-6.41)(P=0.004), respectively. The plasma miR-21 expressions in cisplatin-sensitive group and resistant group were 5.25 (95%CI:0.14-10.64) and 5.82 (95%CI: 2.27-9.37)(P=0.19). The tumor miR-21 expressions in irinotecan-sensitive group and resistant group were 1.09 (95%CI:0.65-1.54) and 4.94 (95%CI:2.44-7.44)(P<0.001), respectively. The plasma miR-21 expressions in irinotecan-sensitive group and resistant group were 1.86 (95%CI:1.08-2.64) and 12.42 (95%CI:3.14-21.70)(P=0.001). Conclusion:A signiifcant correlation was observed between plasma and tumor miR-21 level. The low plasma miR-21 level could benefit from treatment with irinotecan. And low tumor miR-21 expression correlated with increased irinotecan and cisplatin response rate.

A number of medications have been proved to be able to either improve the antitumor effect of chemotherapeutics and molecular targeted drugs or reverse the resistance of tumors to chemotherapeutics and molecular targeted drugs,which are not traditionally used as anticancer drugs.Especially for late-stage tumors after multiple treatments,these agents are good alternatives when used independently or in combination with chemotherapeutics and molecular targeted drugs.These drugs include proton modulators,hypoglycemic agents and cardiovascular agents,etc.

Gastric cancer is the fifth most common cancer and the third leading cause of death globally .Apart from the suc-cessful phase Ⅲclinical trial of trastuzumab and Ramucirumab , other targeted therapies in gastric cancer ( GC) have fallen short or still in early clinical development .In this review, we will summarize the most up to date information on many of the potential actionabledriver genesin gastric cancer and the importance of using the optimal diagnostic test to select for these molecularly defined patients . We focus on the following aspects:HER-2, EGFR, FGFR, MET, IGF-1R and VEGF.

Purpose:To study the effects of hydroxycamptothecin with thermotherapy on anti-angiogenesis in vitro and in vivo. Methods:We chose human microvascular endothelial cell (HMVEC) culture and chick embryo choriallantoic membrane (CAM) model and used MTT and number-calculating methods to observe hydroxycamptothecine on HMVEC’s proliferation , sprouts and CAM blood vessels’ formation.Results:The survival rate of endothelial cells was in the range of (68.2%)-44.7% within the dose of 20-40 ng/ml and 5-80 ng/ml and was negatively correlated with the concentration (correlation coefficient was -0.906,-0.469,P=0.00003,0.0051). Hydroxycamptothecine could significantly suppress the endothelial cells’ proliferation and the sprouts. Hydroxycamptothecine could significantly suppress CAM vessels. The survival rate of HepG II cells is in the range 100%-90% within the dose of 5-80 ng/ml. There was no cytotoxicity.There was a synergestic anti-angiogenetic effect when hydroxycamptothecin (20 ng/ml) was combined with thermotherapy in vitro while there was additive effect when hydroxycamptothecin (40 ng/ml) was combined with thermotherapy in vitro.Conclusions:This experiment shows that small doses of hydroxycamptothecine (20-40 ng/ml) with thermotherapy has anti-angiogenetic synergestic or additive effect on proliferation and migration both in vivo and in vitro.

Purpose:To detect the action of arsenic trioxide(As 2O 3) on the expression of tumor drug-resistant protein. Methods:APL cell line MR 2 resistant to all-trans retinoic acid(ATRA) was used for in vitro studies. APL cell line NB 4 was used for control. The expressions of P-glycoprotein(Pgp), multidrug resistance protein(MRP)were determined by immunocytochemical assays. Results:The expression of Pgp was significantly higher in MR 2 cell line(30%-40%) than in NB 4 cell line(10%-20%)(P