Insulin-like growth factor-1 receptor (IGF-1 R) widely exists in the surface of various types of cells and is closely associated with the formation and development of tumor cells.It also provides a new direction for the targeted therapy for tumors.This article reviews the expression,development,and progression of IGF-1R in pancreatic cancer and research advances in IGF-1R as a target for tumor treatment.

The main biological functions of insulin-like growth factor 1 receptor (IGF-1 R) include formation and maintenance of transformed cell phenotype,involvement in cell proliferation and differentiation,and inhibition of cell apoptosis.In addition,IGF-1R regulates cell cycle and works with epidermal growth factor and platelet-derived growth factor to mediate cells to enter S phase from G1 phase.Overexpressed IGF-1R has become one of the target proteins for diagnostic imaging and localization therapy for primary liver cancer.Inhibition of the expression or function of IGF-1R can effectively control the growth and metastasis of tumor cells and enhance their sensitivity to chemotherapy and radiotherapy.This article reviews the role and significance of IGF-1R and its pathway in the diagnosis and treatment of primary liver cancer.

Objective To observe the efficacy of cumulative dose of polyethylene glycol-interferon (Peg-IFN)α-2a combined with ribavirin in patients with decompensated hepatitis C virus (HCV)-related liver cirrhosis , and to evaluate the effects of anti-virus therapy on the progress of the disease . Methods From January 2005 to March 2009 ,patients with decompensated HCV-related liver cirrhosis were enrolled ,also included patients received partial splenic embolization .Peg-IFNα-2a combined with ribavirin therapy was given to patients whose blood cell met interferon (IFN) therapy standards .The dosage of Peg-IFNα-2a and ribavirin was adjusted according to the tolerance of the patients .After the treatment ,the patients were followed-up for 24 weeks .The patients whose blood cell did not meet IFN therapy standards and the patients unwilling to receive anti-virus therapy were assigned to control group and were followed-up for 96 weeks .The total amount of medication was calculated according to cumulative exposure dose . Sustained virological response (SVR ) , recurrence rate , liver function and disease progression were observed .The t test or Chi-square test was performed for comparison between groups and rate of disease progression was analyzed with Kaplan Meier curve .Results After anti-virus therapy , SVRs of patients with cumulative dose of Peg-IFNα-2a and ribavirin over 60% (include 60% ) were 27 .3%(12/44) and 27 .7% (13/47) ,respectively ;the recurrence rates were 7/19 and 35 .0% (7/20) ,respectively . In patients with cumulative dose less than 60% ,SVRs were 1/7 and 1/4 ,respectively ,and the recurrence rates were both 1/2 ;the differences of different doses was not statistically significant (all P>0 .05) .At the 24th week of follow-up after therapy ,the Child-Pugh score of combined therapy group was 7 .9 ± 1 .4 , which was lower than that before treatment (8 .5 ± 1 .2) ,and the difference was statistically significant (t=2 .33 ,P=0 .02) .At the 96th week of follow-up ,the Child-Pugh score of control group was 10 .0 ± 1 .6 ,which was higher than that before treatment (8 .5 ± 1 .4) ,and the difference was statistically significant (t=5 .82 , P<0 .01) .The disease progression rate of combined therapy group was 15 .7% , which was lower than that of control group (32 .4% ) ,and the difference was statistically significant (χ2=4 .34 ,P= 0 .04) .Conclusion The application of non-standard dosage of Peg-IFNα-2a combined with ribavirin in the patients with decompensated HCV-related liver cirrhosis can achieve virological response once the cumulative dose reached certain standards ,improve Child-Pugh scores of patients and slow disease progression .

Objective To evaluate the effect of midwives′antenatal clinic service on management of gestational weight and birth outcomes .Methods Totally 420 primiparas who had made registration and regular antenatal examination in a hospital ,were randomly divided into two groups .The women in the control group(n=208) received routine antenatal clinicservice .In addition ,the women in the experimental group(n=212) participated in an individual midwives′antenatal clinic .The primiparas′gestational weight gain and birth outcomes were measured and compared between the two groups .Results The rate of natural birth in the experimen‐tal group was higher than that of the control group .The rate of fetal macrosomia ,episiotomy and labor analgesia were lower than that of the control group(P<0 .01) .The rate of naturalbirth ,fetal macrosomia ,episiotomy ,labor analgesia were significantly lower than that of the control group(P<0 .01) .The neonatal weight[(3 250 .58 ± 270 .03)g vs .(3 405 .42 ± 403 .28)g] and volume of bleeding[(199 .13 ± 64 .37)mL vs .(249 .53 ± 93 .56)mL] 2 hours postpartum in the experimental group were significantly lower than that of the control group(t=28 .610 ,P<0 .01 ;t=20 .581 ,P<0 .01) .There were no significant differences in the rate of gesta‐tional diabetes mellitus ,pregnancy‐induced hypertension and fetal distress in uterusbetween the two groups (P>0 .05) .Conclusion The midwives′antenatal clinic service has good effects on management ofgestational weight gain ,improves birth outcomes and pro‐vides primiparas positive experience of childbirth .

As an effective treatment for cancer, chemotherapy not only removes tumor cells, but also produces obvious killing effects on proliferating cells, especially hematopoietic cells, resulting in bone marrow suppression after chemotherapy, and affecting the effects of chemotherapy drug treatment and treatment cycle. Therefore, starting from the aspects of hematopoietic microenvironment damage and hematopoietic stem cell aging, to explore the mechanism of myelosuppression after chemotherapy, which provides new ideas and theoretical support for the intervention and management of bone marrow suppression after cancer chemotherapy.

Objective To establish the laboratory and geography-specific reference intervals for thyroid hormones during pregnancy and changes of serum thyroid hormone in Wuhan. Methods According to NACB guidelines,a total of 1 186 female including in or without pregnancy were recruited in our hospital randomly when they came to routine antenatal clinic. The 2.5 th and 97.5 th percentiles were calculated as the reference intervals for specialty of serum thyroid function including serum thyroid stimulating hormone(TSH),serum free three io-dine thyroid(FT3),serum free thyroxine(FT4)levels during each trimester by chemiluminescence.Results On comparing to non-pregnant women,the serum thyroid hormone in pregnant women had significant difference as the following:(1)FT3 concentrations showed decreased median centile throughout gestation step by step;(2)FT4 lev-els in second and third trimester had slightly decreased;(3)TSH levels had significant decreased in first and sec-ond trimeste and had no significant difference between the early pregnancy and middle pregnancy,and had recoved to the similar level of before pregnancy in middle pregnancy and late pregnancy.Compared with control group,the serum thyroid function levels of pregnant women had significant differences in trimesters. There were 5.84%, 19.09% and 28.91% of women in the first,second and third trimester,respectively,with serum TSH higher than the upper reference limit,or lower than the lower reference limit.Conclusions Serum thyroid function had signifi-cant correlations with pregnancy in Wuhan area. To establish pregnancy-specific thyroid function reference inter-vals of local area can reduce underdiagnosis effectively in thyroid gland related diseases.