Extensive researches suggest that the metastasis of colorectal cancer involves multiple factors and genes.Recurrence and metastasis after surgery are the important reasons for poor prognosis of thesc patients with colorectal cancer.Tumorigenesis is a dynamic process.The levels of tumor markers are changed in different stages.It has not yet been found any kind of tumor markers specific for a certain type of colorectal cancer.The sensitivity and specificity of diagnoising colorectal cancer by detecting an individual tumor marker are not ideal.The better combination of tumor markers has its advantages,can improve the early diagnostic rate.Combining detection of tumor markers will improve the diagnostic yield.

Colorectal cancer is a common malignancy in China.The incidence of it showed an increasing trend with the economic development,living standards improvement and lifestyle changes.The traditional treatment methods include surgery,radiotherapy and chemotherapy.In recent years,hyperthermia has become a method for treating tumor.Hyperthermia kills tumor cells by thermal effect and no-thermal effect.Not only does it have a direct therapeutic effect on tumor cells,hyperthermia also has some synergy combined with radiotherapy and chemotherapy.Hyperthermia combined with conventional therapy can improve the local control rate and extend survival for patients.In this paper,the efficacy of hyperthermia has been reviewed,combined with a variety of treatment methods for colorectal cancer in China.

Since the laparoscopic thyroidectomy carried out in China for ten years,this technique has become more and more mature,indications gradually broadened,and playing a vital role in the field of thyroid surgery.This article will explain this technique in the aspects of approaches,the establishment and maintenance of the surgical space,indications,antiindications and complications.

As one of the most major disease,malignant tumor is harmful to human health.Althought it' s exact pathogenesis is still not clear,it is certainly that the formation of cancer is typical of containing many factors and having gone through many steps.Resulting from the abnormal activation of a series of proto-oncogene as well as the inactivation caused by many anti-oncogene mutation,some signal pathways work abnormally.In recent years,the study of Hedgehog ( Hh),as the signal pathway,shows that Hh encodes a series of secreted signaling protein,having an important effect on the differentiation and proliferation of cells in the process of embryogenesis.The occurrence of abnormal activation of Hh signaling pathway plays a significant role in the process of tumorigenesis.Signal paths of Hh signaling protein include as much as following at least:patched(Ptch),smoothened (Smo),fused (Fu),suppressor of fused (SuFu),costaⅠ-2 (Cos)-2 and cubitus interruptus (Ci) and so on.In this paper,the function of Hh genetic family and the mechanism of its relation to many kinds of human cancers will be givien a brief overview.

There is a long history of Toad venom in the treatment of cancer in China.Bufalin,extracted from Toad venom,is one of the biologically active compounds of anticancer.We elaborate the molecular mechanism of bufalin on anticancer activity from several aspects such as inducing cell apoptosis and differentiation,inhibitting cell proliferation and angiogenesis,enhancing the sensitivity of chemotherapeutics,which can provide the basis for in-depth study of Toad venom and its development and clinical medication.

Colorectal cancer is currently the world's fourth incidence of malignant tumors,the early clinical manifestations are not obvious,so the early diagnosis is difficult to find,most of them are in progress.Treatment of advanced stage with chemotherapy,interventional therapy,radiotherapy and other methods,in which chemotherapy in the killing of tumor cells at the same time,the normal cells of the body also has a killing effect.In recent years,all kinds of new nano targeting delivery system has been developed,which can be targeted to the tumor tissue,so it is more and more important in the treatment of intestinal tumor,especially with metastasis.The author has made an overview of the types of nano drug carrier materials,the research status and its application in the research of colorectal cancer.

It is to difficult to diagnose and treat hepatobiliary surgical diseases since its diverse clinical manifestations,which increases the difficulty of clinical internship.Taking clinical cases as teaching material,case-based learning was combined with teaching theme and was conducted by means of discussion and question and answer between teachers and students.Students can know about concepts or theories related to teaching theme.Case-based learning in internship can consolidate basic knowledge of hepatobiliary surgery,cultivate clinical scientific thinking and is helpful in analyzing and resolving problems of hepatobiliary surgical diseases.

Objective To investigate the significance of metastasis associated lung adenocarcinoma transcript 1 ( MALAT1 ),cyclooxygerase-2 ( COX-2 ),beta catenin ( β-catenin )、matrix metalloproteinase (MMP)-3 and MMP-9 in the occurrence and development of colorectal carcinoma.Methods Real-time PCR was used to detect MALAT1,COX-2,β-catenin,MMP-3 and MMP-9 rnRNA expression in samples from 30 fresh colorectal carcinomas and 30 corresponding adjacent tissues.And the correlation analysis of the gender and age of patients,CEA,immune cellular factors ( CD4 and CD8 ),clinical stages,and the degree of differentiation was undertaken.Results The expression levels of MALAT1,COX-2,β-catenin and MMP-9 were significantly different between colorectal carcinoma tissues and adjacent colorectal tissues (P ＜ 0.05 ).MMP-3 showed no significant difference (P ＞ 0.05).MALAT1,COX-2,β-catenin and MMP-9 expression levels showed an average 2.22-fold,1.86-fold,2.16-fold,0.58-fold ( P ＜ 0.01 ) increase in colorectal carcinoma tissues when compared with adjacent colorectal tissues respectively.There were negative correlation between MALAT1 and β-cateuin ( colorectal carcinoma tissues vs adjacent colorectal tissues) ( r =- 0.346,P =0.030).While there were positive correlation between MMP-9 and β-catenin ( colorectal carcinoma tissues vs adjacent colorectal tissues) ( r =0.312,P =0.047 ).There were significant difference between male patients and female patients in terms of COX-2 and MMP-9 (colorectal carcinoma tissues vs adjacent colorectal tissues) (P =0.047; P =0.018).There were significant difference between patients with tumor marker CEA increase and patients without CEA increase in terms of COX-2 ( colorectal carcinoma tissues vs adjacent colorectal tissues) ( P =0.021 ).Conclusion MALAT1,COX-2,MMP-9 and β-catenin have significance in the occurrence and development of colorectal carcinoma,while MMP-3 has no significant reference value. The negative correlation between MAL(A)T-1 and β-catenin and the positive correlation between MMP-9 and β-catenin might show some interaction relationship in the development of colorectal carcinoma.The expression differences of COX-2 and MMP-9 (colorectal carcinoma tissues vs adjacent colorectal tissues) in male and female patients suggest that above two genes may affect the occurrence ratio of colorectal carcinoma.Detecting of COX-2 maybe helpful to the tumor marker CEA during the diagnosis of colorectal carcinoma.

Objective To study the effect of aquaporin 1 on intestinal capillary endothelial barrier in rats with experimental acute necrotizing pancreatitis (ANP).Methods In this study,160 male Sprague-Dawley rats were randomly divided into five groups:Control group ( n =32),ANP group (n =32),NS group,Dexamethasone group,and Acetazolamide group.Eight rats in each group were sacrificed at 3,6,12 and 18 h after induction of experimental models.Volume of ascites and levels of serum amylases were deternined at each time point.Pathological changes in intestine tissues were observed under electron microscope after HE staining.Capillary permeeabilities in intestine tissues were detected by Evans blue (EB) extravasation experiment.The mRNA and protein expressions of AQP1 in intestine tissue were determined by real-time PCR and Western blotting,respectively.Results Serum amylase level in ANP group was significantly higher than that in control group.Amylase level in dexamethasone group was lower than that in ANP group,and amylase level in acetazolamide group was higher than that in ANP group at 12 h (P ＜0.05 ) ; The concentration of EB in intestine tissues at each time point in ANP group was significantly higher than those in control group,and EB in dexamethasone group was lower than those in ANP group at 6,12 and 18 h.EB in acetazolamide group was higher than that in ANP group at 3 h ( P ＜ 0.05 ) ; The mRNA expression of AQPI in ANP group was significantly lower than that in control group.The expression of AQP1 in dexamethasone group was higher than those in ANP group at 6,12 and 18 h,and the expression of AQP1 in acetazolamide group was lower than that in ANP group at 3,6,12 h in intestine tissue ( P ＜ 0.05 ).Protein expression of AQPI in tissues in ANP group was significantly lower than that in control group.The expression of AQP1 in dexamethasone group increased more than that in ANP group at 3,6,12 h,and the expression of AQP1 in acetazolamide group was lower than that in ANP group at 3 h,6 h ( P ＜ 0.05 ).Conclusions The expression of AQP1 is down-regulated in intestine tissue in rats with acute necrotizing pancreatitis,and AQP1 could play an important role in the pathogenesis of capillary endothelial barrier dysfunction.

Objective To investigate the effects of sorafenib combined with dendritic cells and cytokine induced killer (DC-CIK) cells on the growth,invasion and metastasis of hepatocellular carcinoma.Methods CIK cells and dendritic cells from healthy adults were cultured in vitro.Mice models with H22 hepatic cancer were established,and randomly divided into the normal saline group,sorafenib group,DC-CIK group and the sorafenib + DC-CIK group according to the random number table.There were 40 rats in each group.All the mice received intragastric gavage with sorafenib of 100 μg/g once a day.DC-CIK cells were intraperitoneally injected into the mice every 3 days with 1 × 107 cells each time.Twenty mice bearing tumors in each group were sacrificed after treatment for 3 weeks,and the peripheral venous blood and hepatic tumor tissues were harvested.The levels of alphafetoprotein (AFP) were detected by ELISA,and the necrotic degree of tumor tissues was evaluated by hematoxylin and eosin staining.The protein expressions of Ki-67 and CD34 in the tumor tissues were determined by immunohistochemical method.The survival time of the other 20 mice bearing the tumor in each group were detected.All data were analyzed using the analysis of variance or LSD test.Results CIK cells and dendritic cells were successfully cultured.The levels of AFP in the peripheral venous blood of the normal saline group,sorafenib group,DC-CIK group and sorafenib + DC-CIK group were (0.675 ± 0.177) rg/L,(0.379 ± 0.052) ng/L,(0.415 ± 0.028) ng/L,(0.288 ± 0.012) ng/L,with significant difference between the 4 groups (F =0.415,P ＜ 0.05).The numbers of intrahepatic and peritoneal metastasis of the normal saline group,sorafenib group,DC-CIK group and sorafenib + DC-CIK group were 21.2 ± 1.3 and 29.7 ± 7.6,16.4 ± 1.6 and 17.4 ± 1.8,20.2 ± 1.7 and 26.4 ± 1.7,15.2 ± 1.3 and 15.2 ± 1.3,with significant difference between the 4 groups (F =2.137,3.271,P ＜0.05).The tumor inhibition rate of the normal saline group,sorafenib group,DC-CIK group and sorafenib + DC-CIK group were 0,21％ ± 3％,9％ ± 3％ and 24％ ± 5％,with significant difference between the 4 groups (F =3.715,P ＜0.05).The survival time of mice in the normal saline group,sorafenib group,DC-CIK group and sorafenib ± DC-CIK group were (18.2 ± 2.5) days,(21.6 ± 2.1) days,(24.3 ± 2.8) days and (25.4 ± 1.4) days,with significant difference between the 4 groups (F =6.247,P ＜ 0.05).Conclusions Sorafenib combined with immunotherapy can significantly increase the therapeutic effects of molecular targeted drug on hepatocellular carcinoma.