Hepatocellular carcinoma(HCC) is one of the most common malignant tumors with the highest cause of death and increasing incidence worldwide, and the annual incidence rate is rising. The early diagnosis of HCC is very essential to its prognosis. At present, AFP has been widely used in the survey of HCC diagnosis, therapeutic effect and predict recurrence. However, the sensitivity and specificity of AFP is not satisfactory. In recent years a variety of new serum tumor markers have emerged one after another. A new serum marker-Golgi glycoprotein-73(GP-73) in early diagnosis of HCC is expected to become the new target maker,its sensitivity and specificity are better than AFP.

Objective To investigate the factors affecting the survival and prognosis of patients with stage Ⅲ～ Ⅳgastric cancers.Methods A total of 156 cases of Ⅲ ～ Ⅳ gastric cancer was studied retrospectively from September 1,2006 to December 31,2012.Kaplan-Meier analysis,Log-rank univariate analysis,Cox proportional hazards model analysis were used to analyze survival and prognostic factors.Results Twelve cases were lost,to the end of the follow-up,22 cases were alive.The median survival time was 29.3 months.1-year,3-year,and 5-year overall survival rates were 83.3％,37.8％,and 21.2％,respectively.Univariate analysis showed that tumor size,tumor node metastasis (TNM) staging,curative resection,hyperthermic intraperitoneal perfusion chemotherapy (HIPEC),and postoperative chemotherapy were correlated with prognosis (P ＜0.05 for all).Multivariate analysis showed that TNM staging,curative resection,HIPEC,and postoperative chemotherapy were independent prognostic factors (P ＜ 0.01 for all).Conclusions TNM staging,curative resection,hyperthermic intraperitoneal perfusion chemotherapy and postoperative chemotherapy are the independent factors affecting the prognosis of stage Ⅲ～ Ⅳ gastric cancer after resection.Hyperthermic intraperitoneal perfusion chemotherapy and postoperative chemotherapy can improve their survival.

Objective To investigate the efficacy of precise hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) in the treatment of advanced pancreatic cancer.Methods Thirty-six patients with advanced pancreatic cancer were analyzed retrospectively.Eighteen patients who received HIPEC combined with radiotherapy and chemotherapy were assigned as the treatment group and the other 18 patients who received chemotherapy and radiotherapy were assigned as the control group.Recent curative efficacy,Karnofsky Performance Status (KPS) score,postoperative complications and survivals between the two groups were analyzed,respectively.Results Significant differences were found between two groups in total short-term effective rate (P ＜ 0.05).The total short-term effective rate of treatment group and control group were 66.67％ (12/18) and 27.78％ (5/18),respectively.The increment of KPS score of treatment group was significantly higher than that of control group (P ＜ 0.05).There was no significant difference between two groups in postoperative complications (P ＞ 0.05).The median overall survival time (OS) of treatment group was 11 months (7 ～ 31 months),and the median OS of control group was 7 months (4 ～ 18 months).The survival of the treatment group was longer than the control group (P ＜ 0.05).Conclusions HIPEC treatment improved significantly the survival and life quality of advanced pancreatic cancer patients.With acceptable morbidity and mortality rates,HIPEC regime was an effective treatment modality for patients with advanced pancreatic cancer.

Objective Partial hepatectomy, liver transplantation, and radio frequency ablation for hepatocellular carcinoma (HCC) were compared to select the most suitable method for HCC. Methods 1198 patients with HCC in 3 hospitals in Guangzhou were divided into 3 groups: group Ⅰ , small HCC; group Ⅱ > HCC without vascular invasions and group Ⅲ , HCC with vascular invasion. The patients either received partial hepatectomy, transplantation or ablation. The 1-, 2- or 3-year survival rates, the 3-year recurrent rates and Child-Pugh grades in the 3 groups were compared. Results For small HCC, there was a significant increase in the 3-year survival rate (P<0. 05) and a significant decease in the recurrent rate (P<0. 05) in patients who received transplantation, compared with those who received hepatic resection. Patients who received ablation had a higher 3-year survival rate and a lower recurrence (P<0. 05) in comparison with those who received hepatectomy. There was no significant difference(P<0. 05) between transplantation and ablation, but there were more Child A patients who received hepatectomy and ablation, and more Child B and C patients who received transplantation. For advanced HCC, there was no significant different in the 3-year survival rates for the 3 therapies, but the 3-year recurrence was lower (P<0. 05) in the transplantation group. Conclusions For small HCC, superiority of transplantation versus resection was obvious. Ablation (diameter <3 cm) was also superior to resection, whereas ablation was as effective as transplantation. There were more Child B and C patients in the transplantation group than the ablation and resection groups. Therefore, small HCC with hepatic decompensation should receive liver transplantation. Transplantation was advantageous in having less tumor recurrent but there was no difference in the 3 therapies for advanced HCC.

Objective To study the effect of autogeneic platelet-rich fibrin (PRF) on proliferation and adipogenic differentiation of human adipose-derived stem cells (ADSCs) in vitro.Methods ADSCs were isolated from adipose tissue obtained from donors undergoing liposuction and were cultured,and underwent identification.ADSCs at passage 3 were divided into three groups:test groups were cultured with 1PRFM and 2PRFM,and control group was cultured without PRF membrane.Then the growth of the cells was observed by inverted microscope.MTT method was used to observe cell proliferation activity at days 1,2,3,4,5,6 and 7 after culture.Adipogenic differentiation of ADSCs was observed and quantified by oil red O staining at days 3,5,7,9,11 and 14.Results Cell proliferation and adipogenic differentiation would be increased with the PRFM,There were significant differences among three groups.Conclusions PRF could significantly promote proliferation and adipogenic differentiation of ADSCs.

Objective To investigate the effect of hyperthermic intraperitoneal perfusion and cisplatinon apoptosis in human ovarian cancer cells.Methods Two human ovarian cancer cells (OVCAR-3,A2780) were divided into control group,cisplatin group,hyperthermia group and thermo-chemotherapy group;microscopy was used to observe the morphological changes of the four groups;AO/GV stain and flow cytometry(FCM) was used to analyze cell apoptosis;Apoptosis related genes caspase7,caspase8 and Bax in ovarian cancer cells were detected by fluorescence quantitative PCR.Results Inverted microscopy observeed that the ovarian cancer cells retracted and suspended partially in the cisplatin group and hyperthermia group,especially in the thermo-chemotherapy group.After AO/GV staining,the apoptotic cells were increased in the cisplatin group and hyperthermia group compared with the control group,and the thermo-chemotherapy group was more than cisplatin group and hyperthermia group.FCM results indicated that the proportion of cells apoptosis were higher in the cisplatin group and hyperthermiagroup,the thermo-chemotherapy group is the higher than the all other groups(P＜0.05).q-PCR results showed that in the thermo-treatment group the expression of pro-apoptotic genes,including caspase3,caspase6,caspase7,caspase8,caspase9,Bax,Bak and Bid,was significantly higher than other groups,apoptosis inhibitory gennes,such as Bcl-2,Bcl-xL,Mcl-1,c-FLIP,was significantly decreased than the others.Conclusions Cisplatin plus hyperthermia can promote the apoptosis in ovarian cancer cells.

Objective To study the construction of training bases for three tumor therapies. Methods Eight training bases in six third-level first-class hospitals with score of technology assessment higher than 90 were investigated. Results There were good hardware in all training bases and qualified teaching staff in six of them. Annual operative quantity of hyperthermia and radioactive particles implantation technology of all training bases were up to the standard , while the coincidence rate of ablation technology was 80%. Besides , quantity of ablation technology and radioactive particles implantation technology trainees participated in during training met the standard, but that of hyperthermia not. There were significant difference in theory and operational test results before and after training (P < 0.01). Conclusions Management system, operative quantity and teaching staff construction need to be improved. Clinical skills training and standardized training assessment should be strengthened in base construction.

Objective To investigate the measurement , feasibility and clinic effect of hyperthermic intraperitoneal chemotherapy (HIPEC) guided by B ultrasound in the treatment of malignant ascites from peritoneal carcinomatosis. Methods From July 2011 to June 2013, B ultrasound-guided approach was used to perform HIPEC on 36 patients affected by malignant ascites secondary to peritoneal carcinomatosis. Every patient underwent HIPEC for three times , by way of continuous circulatory perfusion into peritoneal cavity with saline at 400 ~ 600 mL/min and intraperitoneal perfusion with 5-FU mitomycin-C and cisplatin for 90 minutes with an inflow temperature of (43 ± 0.2)℃. These patients were followed up for a long term. Results Intraoperative course was uneventful in all cases. Complete clinical regression of ascites and related symptoms was achieved in all the 26 patients, partial regression achieved in 8 patients, and no curative effect achieved in 2 cases. The acquired total clinic effectiveness was 94.44%. No postoperative deaths and complication related to the procedure occurred in this study. The KPS grades of patients rose (P < 0.001), the level of tumor markers decreased, including CA199 (P < 0.001), CEA (P < 0.001), CA125 (P = 0.003). Conclusion HIPEC guided by B ultrasound appears to be a safe, feasible and effective procedure for the treatment of debilitating malignant ascites from unresectable peritoneal carcinomatosis , which would have a clinic good perspective in future.

Objective To investigate the effective regimen to treat the hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT). Methods The clinical data of 4 cases of HCV recurrence after OLT were retrospectively analyzed. Of the 4 cases, there were 3 cases of HCV related liver cirrhosis and 1 case of HCV related liver cirrhosis in combination with hepatocellular carcinoma. The immunosuppression regimen as FK506, MMF and corticosteroids was used after OLT. As soon as HCV recurrence was confirmed by liver biopsy during 8 to 12 weeks after OLT, pegylated interferonα-2a (PEG-IFNα-2a) and ribavirin (RIB) were used for 48 weeks. PEG-IFNα-2a was started at a dose of 180 μg per week subcutaneously and RIB at a dose of 1000 mg per day orally, respective-ly. Blood routine, liver and kidney function test, HCV-RNA and transplanted liver biopsy were per-formed when necessary and biochemical response, sustained virologic response and histological re-sponse were tested in due time. Remits All of the 4 cases except for 1 achieved sustained virologic re-sponse and the liver function was as normal as before. The histological activity index was improved significantly for both inflammatory activity and fibrosis according to liver biopsy in 0, 48, 72 week srespectively. Case 4 was given corticosteroids for consecutively 3 days when acute rejection was veri-fied by liver biopsy and the condition improved. None of them stopped treatment or withdrew from them directly. Conclusion The combination of PEG-IFNα-2a and RIB was an effective regimen to treat the HCV recurrence after OLT and the side effects could be overcame easily.

BACKGROUND:Mouse pluripotent stem cel s are induced to differentiate into insulin-secreting cel s that can effectively improve blood glucose levels in diabetic mice. OBJECTIVE:To detect mRNA and protein levels of insulin-like cel clusters from induced pluripotent stem cel s and to investigate the function of insulin-secreting cel s in vitro and in vivo. METHODS:Mouse induced pluripotent stem cel s cultured in vitro were induced to differentiate into insulin-secreting cel s using combined inducers through three stages. The morphology of endodermal cel s, islet-derived progenitor cel s and mature islet cel s in each stage was observed and relative gene expression levels were detected by PCR. Mature insulin-like cel clusters underwent dithizone staining and functions of insulin released in vitro were observed by ELISA assay. Final y, the insulin-secreting cel s were transplanted into the subrenal capsule of diabetic mice, and then blood glucose levels were observed. RESULTS AND CONCLUSION:The mature spherical insulin-like cel clusters were successful y obtained in vitro, which were in iron red by dithizone staining, and expression of insulin mRNA was determined by PCR. The insulin-like cel clusters could secrete insulin in response to various blood glucose levels by ELISA assay. In addition, after the cel s clusters were transplanted into the subrenal capsule of mice with type 1 diabetes, the blood glucose levels were marbedly improved.