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 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.

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.

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.

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.

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.

Resistance is one of the most important reasons that restrict the clinical application of most chemotherapeutic medicines. Docetaxel is a very widely applicated antitumor medicine. Most of the researches on the mechanism of resistance against docetaxel focused on the drug transporters, changes in drug metabolism and pathway alteration of cell cycle and apoptnsis. The mechanism of docetaxel resistance and the predictive data based on clinical research to docetaxel therapy in cancer treatment were reviewed.

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.

Objective To evaluate the effects of double collagen and epidermal growth factor (EGF) on morphology, viability and function of Sprague-Dawley (SD) rat hepatocytes after cryopreservation and thawing. To investigate a kind of more ideal liver cell cultivation in situ, for offering the most basic material in liver cell transplantation.Methods Rat hepatocytes were isolated by a two-step collagenase technique and cultured in different conditions. After freeze-thaw-cycle, the viability and function of the cells were measured. Results The viability and function of hepatocytes in collagen and in collagen with EGF groups were prior to those in other groups. ( P

Objective: To study the expression of vascular endothelial growth factor(VEGF) in small cell carcinoma of cervis(SCCC) and its relationship with the clinical and pathological features,so as to predict the metastasis of SCCC,to evaluate the prognosis and to manage a proper treatment. Methods: EnVision two step immunohistochemical method was used to observe the expession of VEGF in the samples of small cell carcinoma of cervis. Results: Four samples were obtained from surgical specimens of the patients with SCCC in our hospital.In all the samples,the expression of VEGF was positive. Conclusion: VEGF is closely related with the oncogenesis and development of SCCC.In the earlier period of SCCC,the lymph node involvement and vascular invasion are common.The aggressive progression of SCCC must have something to do with the highly expression of VEGF.The expression of VEGF can be used as an index in selecting treatment and predicting prognosis of SCCC.