Hepatocellular carcinoma(HCC) is one of the most common malignant tumors in the world.According to the statistic data of Ministry of Public Health of China in 1995, the annual mortality of HCC was 20.4 per 0.1 million, and had the rise tendency. Surgery is commonly the main modality of HCC combined therapy. The high intensity focused ultrasound (HIFU), as a noninvasive therapy, with the mechanism of transient high temperatures, cavitation and mechanical effects, has been recognized. This review aimes to elucidate the immune changes in HCC after HIFU exposures and the mechanism.

Objective To investigate the relation between polymorphisms of pulmonary surfactant protein A gene and adaptation to hypobaric hypoxia. Methods The genotype proportions and allel frequencies of 86 Tibetan mountaineers and 90 sea-level Hans were examined with polymerase chain reaction-sequence specific primer(SSP-PCR) reaction for surfactant protein A gene. Results The constituent ratio of A/A,A/G and G/G genotypes in A1-aa62 locus and C/C,A/C and A/A genotypes in A2-aa223 locus showed significant statistic difference between highland group and the sea-level control group(P＜0.05). A1-aa62 G/G and A2-aa223 A/C genotype demonstrated high odds ratio in Tibetan mountaineers. Moreover, the comparisons of genotypes and alleles in A1-219 locus showed no significant difference between the plateau group and the sea-level Han control(P＞0.05). Conclusion The single-nucleotide polymorphisms(SPN) in SP-A1aa62 and SP-A2aa223 may be associated with the adaptation to hypobaric hypoxia.

OBJECTIVE:A RP-HPLC method was established for determination of serum concentration of propofol in man METHODS:The mobile phase consisted of methanol-water(68∶32v/v)The detection was carried out at wave length 258nm and flow rate 1ml/min with carbamazepine as internal standard RESULTS:The retention times of propofol and carbamazepine were 9 20 and 5 16 min,respectively The mean recovery of propofol was 99% The within-day and inter-day variations were all less than 10% Propofol and carbamazepine were seperated well The assay linearity was obtained in the range of 1～16?g/ml in serum(r=0 9 994) CONCLUSION:The method is sensitive,simple and reliable for the determination of propofol concentration

Objective To explore the relationship between serum creatinine ( Scr ) , blood urea nitrogen ( BUN) and lung image changes in uremic patients .Methods According to the chest CT ,X-ray and related findings , 256 patients with uremia were divided into 84 cases of uremia ( uremic lung group ) and non-uremic lung 172 cases ( non-uremic lung group ) .The chest CT and X-ray examination ,Scr and BUN levels were observed .Results Uremic lung group had five types of image findings,including alveolar edema (67.86%),pulmonary interstitial edema (16.67%),pulmonary congestion syndrome(8.33%),pleural effusion(4.76%) and pulmonary interstitial fibrosis (2.38%).The Scr[(1 145.6 ±236.4)μmol/L]and BUN [(38.9 ±6.1)mmol/L]levels in uremic lung group were significantly higher than those in the non-uremic lung group[(905.3 ±138.9)μmol/L,(23.8 ±5.6)mmol/L](t=8.128,4.782,all P<0.05).Conclusion The image of uremic lung is mainly pulmonary edema ,and radiological and pathological changes are closely related with Scr and BUN levels .

OBJECTIVE： A RP－ HPLC method was established for determination of serum concentration of propofol in man METHODS： The mobile phase consisted of methanol－ water（ 68∶ 32v/v） The detection was carried out at wave length 258nm and flow rate 1ml/min with carbamazepine as internal standard RESULTS： The retention times of propofol and carbamazepine were 9 20 and 5 16 min， respectively The mean recovery of propofol was 99％  The within－ day and inter－ day variations were all less than 10％  Propofol and carbamazepine were seperated well The assay linearity was obtained in the range of 1～ 16μ g/ml in serum（ r=0 9 994）  CONCLUSION： The method is sensitive， simple and reliable for the determination of propofol concentration

Objective To evaluate the clinical outcome of reconstruction of traumatic digital arthritis by transfer of free proximal interphalangeal joint of the second toe with toe reserving technique.Methods The study enrolled nineteen patients with traumatic digital arthritis treated from May 2013 to April 2016.The patients consisted of fifteen males and four females,and mnean age was 27.3 years (range,18-52 years).Finger involved included index fingers in 10 patients,middle fingers in seven and ring fingers in two.The joint of digit was reconstructed by transplanting the proximal interphalangeal joint of the second toe with a monitoring flap,and bone defect of the second toe was repaired with autogenous iliac bone graft.Wound was closed directly in six patients and covered by island flap from the foot dorsurn in 13 patients.Evaluation indicators contained survival rate of the free joint and island flap,appearance and fracture healing of the finger and toe and mnotion of the proximal digital joint.Finger function was studied using the evaluation standard of upper limb function set up by hand surgery branch of Chinese Medical Association.Healing in the donor site,foot function and related complications were observed.Results All the free joint and island flap survived.Period of follow-up was 6-30 months (mean,14 months).The fractured finger healed at 2.5 months on average,and appearance of the finger was good.Flexion range of the proximal digital joint was 63 °-80° (mean,74°) and extension range was-20°--10° (mean,-14°).Finger function was excellent in eleven patients and good in eight patients,with the excellent-good rate of 100％.Hematoma of the dorsal region of the foot occurred in one patient and the cut healed well after taking out some stitches and drainage.All fractured toe healed at 2.6 months.Except that one patient had fracture malunion with minor outward inclination,all presented good appearance of the toe without influencing walking and running.On the part of iliac,there was only one inconspicuous linear scar without any discomfort.Conclusions Transfer of free proximal interphalangeal joint of the second toe with toe preservation restores the anatomy structure and function of the digital joint.Meantime,autogenous iliac bone grafting combined with island flap from the foot dorsum for coverage of donor site defect retains the toe length and reduces injury of the donor site.

Objective To investigate the feasibility of the virtual source model in Monte Carlo dose calculation for clinical radiotherapy.Methods The Monte Carlo simulation was used to obtain the phase space files which recorded the physical properties of the particles emitted by a medical linear accelerator, and the information on the type, energy spectrum, and distribution of particles were extracted from these files and analyzed to establish the semi-empirical model of virtual two-photon source.The GMC dose calculation engine was used to obtain the 3 cm×3 cm, 5 cm×5 cm, 10 cm×10 cm, 20 cm×20 cm, and 30 cm×30 cm fields of radiotherapy and the results of Monte Carlo simulation of dose distribution in three-dimensional water phantom in 2 intensity-modulated radiotherapy ( IMRT) plans.These results were compared with the results of water phantom measurement or the results of Elekta Monaco planning system to verify the accuracy of Monte Carlo dose calculation based on a virtual source.Results As for the percentage depth-dose distribution curves of the central axis of the water phantom and the off-axis dose curves at different depths in the five fields for radiotherapy, the difference between the results of Monte Carlo simulation and the results of measurement was within 1%.As for the two IMRT plans, the three-dimensional passing rates of Monaco calculation results and Monte Carlo simulation results were 98.9%and 99.4%, respectively, for 3%/3 mm, and 95.1%and 95.4%, respectively, for 2%/2 mm.Conclusions Monte Carlo simulation based on the virtual source model can obtain accurate results of radiotherapy dose calculation.

Objective To study the impacts of different applicators on dose distribution in 192 Ir brachytherapy. Methods The inner tubes of two cylinder applicators from Nucletron,#101?001 and#084?350, were made of plastic and stainless steel, respectively. The cylinder parts of them were made of plastic, and had four different radiuses:1?00 cm, 1?25 cm, 1?50 cm, and 1?75 cm. EGSnrc program was used to simulate dose distribution when applicators were present in a phantom, and the results calculated by the treatment planning system were compared with the results of EGSnrc. The impacts of applicators on dose distribution were analyzed with different materials, thickness, and numbers of resident source. Results There was no significant relationship between dose deviation and the radius for the two applicators. When an applicator was present, the actual dose delivered to a patient was smaller than the planned dose. The dose deviation of the applicator#101?001 was no more than 1%, while the dose deviation of the applicator#084?350 was close to 3%. The dose deviation remained the same when the number of resident source changed. Conclusions The plastic applicator, if possible, is the best choice for brachytherapy right now. In a long term, in order to promote the accuracy of brachytherapy, current dosimetry algorithm should be improved, and the impacts of the applicator made of metal, such as stainless steel, on dose distribution should be taken into account.

ObjectiveTo study of the impact on dose distribution by electron width of energy spectrum and angular distribution using Monte Carlo simulation.MethodsThe simulated electron energy spectrum and angular distributions was as the input parameters and percentage depth dose (PDD) and offaxis curves were simulated by a modified PENELOPE code package. Results PDD and off-axis dose distribution curves are almost the same and are not sensitive to energy spectrum width and angular distribution with the exception of energy spectrum width of 2.5 MeV with obviously different curves.ConclusionsIn the situation of clinical treatment,spectrum and angular distributions can be ignored when their width are not very large.It is helpful to save about 9％ time by using monoenergy beams in treatment planning system development.

Objective To explore the role and mechanism of keratin 19 (KRT19) in breast cancer.Methods Quantitative real-time polymerase chain reaction (qRT-PCR) assay was used to determine KRT19 levles in 35 cases of breast cancer tissues and normal tissues.The correlation between KRT19 levels and clinical property of breast cancer was analyzed.Meanwhile,the expression levels of KRT19 in several breast cancer cells and mammary epithelial cell Michigan cancer foundation (MCF)-10A were evaluated by qRT-PCR assay.Over-expressed and knocked-down KRT19 in breast cancer ceils,3-(4,5-dimenthylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was performed to detect the proliferation and chemosensitivity of these cells.The ability of forming colon of these breast cancer cells with treated KRT19 was studied via colony-forming unit assays.Western blot assay was performed to determine expression levels of ceil cycler related proteins.Results KRT19 was upregulated in breast cancer tissues comparing to normal tissues.KRT19 was positively related to tumor node metastasis (TNM) stage and distant metastasis of breast cancer.Similarly,KRT19 was highly expressed in breast cancer cells compared to mammary epithelial cell MCF-10A.The proliferation and colony-forming ability was significantly enhanced in MCF-7 cell with o,verexpressed KRT19.MTS assay showed that chemosensitivity of MCF-7 cells with overexpression of KRT19 was much more remarkably reduced than the control group.However,knocking down KRT19 in breast cancer cells MDA-MB-231 got the opposite results.Western blot assay suggested that KRT19 could obviously upregulated cyclin-dependent kinase 1 (CDK1) but not p27 expression levels.Conclusions KRT19 was upregulated in breast cancer tissues and was positively related to TNM stage and distant metastasis of breast cancer.KRT19 can significantly enhance proliferation and chemoresistance of breast cancer cells via upregulating CDK1.