Objective To study the significance of treating advanced primary hepatic carcinoma by using the different methods combined with chemotherapy. Methods One hundred and fifteen cases with advanced primary hepatic carcinoma were divided into 5 groups by accepting different chemotherapy: the groups of interventional-chemotherapy (group A, 40 cases), whole body hyperthermia combined with chemotherapy (group B, 16 cases), only chemotherapy (group C, 9 cases), local heat chemotherapy (group D, 26 cases), symptomatic supportive (group E, 24 cases) for comparing response rate (RR) and survival time between each other. Results The RR in group A,B,C were 30.5 % (12/40), 12.5 % (2/16), 11.1 % (1/9) respectively, and there was no significant difference among three groups (P>0.05). The mid-survival time of five groups were 7.7, 9.2, 7.9, 6.0, 4.7 months, and there was significant difference between group B and group E (P<0.05). The 0.5-, 1-, 2-year survival rate in group B were higher than those in group E with significant difference (81.2%vs. 29.1%, 37.5%vs. 12.5%, 12.5%vs. 0, all P<0.05). Conclusions The RR of only routine chemotherapy is low, while the RR of interventional-chemotherapy and local heat chemotherapy is high with non-prolonged survival time. Whole body hyperthermia combined with chemotherapy have active effects in helping to improve the efficacy and prolong the survival time in retreatment patients with advanced hepatic tumor.

Objective Combination of nanoparticle with p53 and Rb gene therapy by gene targeting was applied to investigate its curative effect and safety evaluation on colorectal rabbit hepatic VX2 metastasis for tumor eradication and survival enhancement. Methods Recombinant expressing plasmids harboring wild type p53 and Rb were cotransferred or transferred separately to the rabbit hepatic VX2 metastasis by the emulsion of PLL-nHAP nanoplex and lipodiol through the hepatic artery in a tumor target manner. Subsequent co-expressions of p53 and Rb protein within the treated tumors were detected by Western blot and in situ analysis of confocal laser scanning microscope. The therapeutic effect was evaluated by the tumor growth velocity and the survival time of animals. Eventually, investigations of liver function were applied to evaluate the safety of the process. Results With safe procedure for the rabbits liver function, both p53 and Rb local nano-therapy showed favorable anti-tumor effects and increased animal survival time. p53+Rb local nano-therapy could significantly inhibit hepatic VX2 metastasis and enhance the animal survival time compared with p53 local nano-therapy or Rb local nano-therapy. Local nano-therapy showed no significant influence to animal liver function. Conclusions Rb can work synergistically with p53 in the combined therapy mediated by PLL-nHAP nanoplex to augment the anti-tumor effect. The local nano-therapy with p53 and Rb is likely to be an effective and safe anti-tumor therapy for hepatic colorectal metastasis.

Objective To observe the effect of a novel pressure controlled water jet used in transurethral resection of bladder tumor. Methods Clinical data of 12 patients who underwent a transurethral resection of bladder tumor by using a novel water jet was retrospectively analyzed. Results All 12 cases were successfully operated. Estimated blood loss during operation was less than 5 ml. Operation time was 20-45 minutes (median was 28 min), time of water injection was 8-15 minutes (median was 12 min). There were no significant complications. All patients were followed up for 4-10 months, and tumor recurrence or progression was not found by cystoscopic examination. Conclusion Transurethral resection of bladder tumor by using a novel pressure controlled water jet is advantageous with favorable safety and feasibility.

Objective To explore the clinical characteristics and prognostic factors of patients with hepatolithiasis associated with intrahepatic cholangiocarcinoma. Methods The clinical data of 39 patients with hepatolithiasis associated with intrahepatic cholangiocarcinoma in the First Affiliated Hospital of Chongqing Medical University from Jan 2006 to Jun 2013 was retrospectively analyzed. Results The main clinical manifestations of hepatolithiasis associated with intrahepatic cholangiocarcinoma included recurrent fever, abdominal pain, jaundice and hepatic percussion pain. Among the 39 cases, the patients older than 60 years accounted for 69.2 % (27/39), and the duration of hepatolithiasis more than 10 years accounted for 76.9 % (30/39). Remarkable differences were found in serum CA19-9 and surgery methods (both P< 0.05). Conclusions Recurrent fever, abdominal pain, jaundice and hepatic percussion pain are the main clinical manifestations for the patients who are diagnosed with hepatolithiasis associated with intrahepatic cholangiocarcinoma. Advanced age and longer duration of the disease may be the high risk factors. Serum CA19-9 levels and surgical methods are the important prognostic factors.

Objective To investigate the association between the positive rate of circulating tumor cells (CTC) and clinicopathological parameters, recurrence and metastasis in patients with colorectal cancer. Methods 7.5 ml peripheral blood of 138 cases of newly diagnosed colorectal cancer who met inclusion criteria, 82 post-operative cases of colorectal cancer and 34 healthy controls were collected. The CTC was enriched by beads which packaged the anti epithelial cell adhesion molecule and counting the CTC (CK+ DAPI+ CD45-). To investigate the association between the preoperative positive rate of CTC and clinicopathological parameters, and the relationship between the positive rate of CTC and recurrence and metastasis in post-operative colorectal cancer patients who have not accepted any therapy more than one month. Results The positive rate of CTC in patients with colorectal cancer and healthy controls were 47.1%(65/138), and 0 (0/34) respectively, and the difference was statistically significant (χ2= 25.743, P< 0.001). No association between CTC positive rate and age, gender, primary tumor site, T staging, platelets, cancer embolus, NK cells, regulatory T cell was observed (all P> 0.05); The significant association between the positive rate of CTC and N or M staging was found. CTC positive rates in N0, N1, N2 stage were 38.3 %(23/60), 37.9 % (11/29), and 63.9 % (23/36) respectively (χ2= 6.819, P= 0.033); CTCs positive rates of M0, M1 stage were 38 . 0 % ( 38/100 ) and 71 . 1 % ( 27/38 ) respectively , and there was a statistical difference (χ2= 12.074, P= 0.001). In 82 post-operative cases of colorectal cancer, the positive rates of CTC were 51.6 % (32/62) and 90.0 % (18/20) in non-recurrence and recurrence, respectively, and the difference was statistically significant (χ2=9.365, P=0.002). Conclusion CTC detection may assess the occurrence of metastasis and recurrence in colorectal cancer patients.

Objective To observe the expressions of Slug, BRAF V600E and STIP1 proteins in papillary thyroid carcinoma (PTC), and to explore their correlation with capsular invasion and regional lymph node metastasis. Methods Slug, BRAF V600E and STIP1 expressions in 107 cases of differentiated PTC were examined by immunohistochemical staining. The expressions of three proteins and clinicopathological data were statistically analyzed. Results Positive rates of Slug, BRAF V600E and STIP1 in PTC were 65.4 % (70/107), 61.7 % (66/107) and 66.4 % (71/107), respectively, and overexpression of Slug, BRAF V600E and STIP1 was significantly associated with capsular invasion and regional lymph node metastasis in PTC (P< 0.05). There are a significant correlation between expression of Slug and BRAF V600E in PTC (r= 0.235, P< 0.05). Conclusion Overexpression of Slug, BRAF V600E and STIP1 proteins is associated with capsular invasion and regional lymph node metastasis in PTC, which maybe useful for predicting regional lymph node metastasis and prognostic evaluation.

Objective To investigate the clinical effects and advantages of flexible 3D laparoscopic surgery on rectal cancer after neoadjuvant chemoradiotherapy (nCRT). Methods The data of 152 patients who received laparoscopic rectal cancer resection after nCRT excluding the cases of high rectal cancer, cardiac and pulmonary dysfunction were analyzed from January 2015 to January 2016 in the Department of Colorectal Surgery of Liaoning Cancer Hospital. The distances from the annal edge to the inferior tumor margin were within 8 cm in these patients. Among these patients, 76 cases received the 3D laparoscopic surgery after nCRT (3D-nCRT), and 76 cases undergone the 2D laparoscopic surgery after nCRT (2D-nCRT). Results Between two groups, the number of lymph node harvest (14.8±2.1 vs. 14.3±1.7), positive rate of the distal margin [1.3 % (1/76) vs. 2.6 % (2/76)], reserving anus rate [92.1 % (70/76) vs. 81.2 % (67/76)], local recurrence rate [1.3 % (1/76) vs. 3.9 % (3/76)] and anastomotic leakage rate [2.6 % (2/76) vs. 3.9 % (3/76)] had no statistical differences (all P>0.05), while the operative time [(125.3±10.2) min vs. (136.6±12.0) min], intraoperative bleeding [(54.1±23.2) ml vs. (61.9±19.5) ml], anus exhaust time [(43.5±5.0) h vs. (45.4±5.6) h] and positive rate of circumferential resection margin (CRM) [1.3 % (1/76) vs. 9.2 % (7/76)] had statistical differences (all P< 0.05). Conclusion Flexible 3D laparoscopic surgery on rectal cancer after nCRT can shorten operative time, reduce intraoperative bleeding, alleviate the influence of intestinal peristalsis function, and improve operative quality.

Objective To explore the methylation status of Rap1 GTPase activating protein (Rap1GAP) promoter in colon cancer, and to provide the oretical basis and research direction for the early diagnosis, targeted therapy, anti-multidrug resistance of colon cancer and so on. Methods The paraffin embedded specimens of 33 patients with colonic adenocarcinoma diagnosed by pathology were analyzed from Department of Pathology of Xinzhou City People′s Hospital from January 2010 to September 2014, including 19 males and 14 females, and aged 41-72 years old. The paraffin embedded specimens of 16 patients with colonic adenoma were enrolled, including 9 males and 7 females, and aged 34-58 years old. 13 normal tissues from the tumor distal margin (from the tumor > 15 cm) were selected. Quantitative methylation specific PCR (q-MSP) was applied to detect methylation level of Rap1GAP gene promoter. The methylation level differences of Rap1GAP gene promoter region among 3 groups or between different clinicopathologic factor subgroups were compared. Results The methylation rates [median (interquartile range)] of Rap1GAP promoter were 65.43 % (50.35 %), 21.37 % (8.39 %) and 17.43 % (15.71 %) in colonic adenocarcinoma group, colonic adenoma group and adjacent normal tissue group, respectively. The methylation rate of colonic adenocarcinoma group was significantly higher than that of colon adenoma group or that of adjacent normal tissue group (P< 0.05). The methylation rates of Rap1GAP promoter in colonic adenocarcinoma were not correlation with age, sex, differentiation and the stage of TNM [ male vs. female: 42.74 % (70.44 %) vs. 21.98%(80.00%);≤60yearsoldvs.>60yearsold:36.26%(62.62%)and26.23%(76.42 %);well-differentiated vs. moderately/poorly-differentiated: 21.98 % (40.32 %) vs. 42.74 % (74.20 %); TNM Ⅰ-Ⅱ vsⅢ-Ⅳ: 25.31 % (48.27 %) vs. 36.26 % (75.55 %); all P> 0.05]. Conclusion The methylation status of RAP1GAP promoter maybe associate with genesis and development of colon cancer, which might be used as a target for early diagnose of colon cancer.

Objective To analyze the efficacy and safety of different chemotherapy regimens for treatment of progressive patients with small cell lung cancer (SCLC) brain metastasis after radiotherapy. Methods 96 SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy were divided into four groups: carmustine group (Group A, 28 cases), temozolomide group (Group B, 19 cases), topotecan group (Group C, 24 cases) and no chemotherapy group (Group D, 25 cases). Results In terms of brain metastases, there were no complete response cases in the whole groups. The rates of partial remission (PR), stable disease (SD) and progression of disease (PD) in Group A were 17.8%(5/28), 53.6%(15/28) and 28.6 % (8/28), respectively, the response rate (RR) of intracranial lesions was 17.9 % (5/28), and disease control (CR+PR+SD) rate was 71.4%(20/28). The rates of PR, SD and PD in Group B were 15.8%(3/19), 63.2 % (12/19) and 21.1 % (4/19), respectively, the RR of intracranial lesions was 15.8 % (3/19), and disease control rate was 78.9 % (15/19). The rates of PR, SD and PD in Group D were 8.3 % (2/24), 54.2 %(13/24) and 37.5 % (9/24), respectively, the RR rate of intracranial lesions was 8.3 % (2/24), and disease control rate was 62.5 % (15/24). In Group D, there was no response case, and 20 patients with PD (80.0 %) were found. The median progression-free survivals (PFSs) were (3.64 ±0.43) months, (4.68 ±0.49) months,(3.58 ±0.50) months, (2.60 ±0.31) months in Group A, B, C and D, respectively, and the median overall survivals (OSs) were (18.80±1.74) months, (18.76±1.85) months, (19.10±1.64) months and (9.64±0.84) months, respectively. The median OS of Group A, B or C was longer than that of Group D (P=0.002). The differences of grade Ⅲ-Ⅳhematologic toxicities among the four subgroups were not statistically different. Patients in Group B had better tolerance to nausea and vomit. In Group D, the central nervous system symptoms such as fatigue and headache occurred frequently. Conclusions The response rate and OS of SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy are improved after chemotherapy, however, PFS is not significantly prolonged. The efficacies of carmustine, temozolomide and topotecan are similar in short and long term, besides, temozolomide shows less adverse events and a higher disease control rate. The application of chemotherapy that could penetrate the blood-brain barrier can improve the efficacy on SCLC brain metastasis patients with progressive intracranial lesions after radiotherapy with well tolerance.

Objective To investigate the effects of cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis. Methods A prospective study method was used, and 76 cases of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis from February 2013 to October 2015 in our hospital for diagnosis and treatment were selected. According to the open control paired principle,the patients were equally divided into observation group and control group, each of 38 cases. Both groups received subtotal temporal bone resection in the treatment, and the observation group received cochlear implant therapy. The surgical effect and hearing improvement of two groups were observed. Results All patients successfully completed surgery. In the observation group, the patients showed normal reactions to intraoperative electrode detection and postoperative electrode impedance, without electrode slippage. There were no statistical differences between the two groups in postoperative pneumothorax and other complication (P>0.05). The sound intensity level of hearing test in postoperative 1 month in the observation group and control group were (21.23±5.22) dB and (28.42±4.19) dB, which was significantly lower than that in the preoperative 1d [(38.24 ±4.98) dB and (38.12 ±5.00) dB], with significantly statistical difference (P<0.05). The postoperative 1 month of hearing and speech score in the observation group were (87.24 ±2.98) points and (82.10 ±3.91) points respectively, which were significantly higher than those in the control group [(73.02 ±5.30) points and (71.84 ±3.11) points] (P<0.05). The two groups of postoperative 1 months of hearing and speech scores were also significantly higher than those in the preoperative 1 d [observation group: (34.29±3.49) points and (32.10±5.30) points; control group: (33.20±4.14) points and (31.98±4.92) points] (P<0.05). Conclusion Cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis shows high safety and success rate, which can promote the improvement of hearing and speech ability, and be widely used in clinic.