ObjectiveTo investigate the effects of X-linked inhibitor of apoptosis (XIAP) siRNA or XIAP antagonist Embelin on the growth inhibition and apoptosis of hepatcellular cancer cell line HepG2,which was treated by tumor necrosis factor-related apoptosis (TRAIL). Methods HepG2 cells were tranfected either by XIAP siRNA or a negative control,followed by treatment with TRAIL,Embelin or a combination of the two.XIAP expression,cell growth,and caspase-3 activity were determined by Western blot,MTT assay and fluorescent caspase-3 assay,respectively.Cleaved PARP expression levels of were measured by Western blot.ResultsThe XIAP protein expression was significantly downregulated by transfection with XIAP siRNA.Compared with the negative control,the XIAP siRNA significantly inhibited the growth of HepG2 cells treated by 100ng/ml(6.8％ ±1.2％ vs.11.8％±4.0％,P＜0.05)and 1000 ng/ml (18.9％ ±2.0％ vs.26.6％ ±1.5％,P＜0.01)by TRAIL.TRAIL-induced caspase-3 activation and PARP cleavage were also increased significantly by XIAP siRNA transfection.In addition,Embelin also significantly inhibited cell growth (P＜0.01),activation of caspase-3 (P＜ 0.01) and TRAIL-induced PARP cleavage.Conclusions Both XIAP siRNA and Embelin may potentially contribute to clinical treatment of hepatocellular carcinoma.

Objective To study the diagnosis and treatment of ectopic testes. Methods 7 cases of ectopic testes were reviewed and studied. Results 5 cases of ectopic testes were diagnosed and located by physical examination and/or type B ultrasonography before operations whereas the ectopic testes was atrophic in the other two.All the ectopic testes were found successfully during surgical exploration.Orchidopexy was performed for 5 patients,and orchiectomy for the other 2 because of marked atrophy.Postoperative follow up has been 2 months to 8 years.All the patients have normal growth.In the 5 cases with reposited testes no displacement,atrophy or malignant change has been noted. Conclusions The diagnosis of ectopic testes should be mainly depended on physical examination and type B ultrasonography.Surgical exploration should be carried out through the inguinal canal and via the pathway of spermatic cord.

Objective To investigate the relation between the apotosis of B cells in the peripheral blood (PB) and the expression of interleukin (IL)-17 in patients with rheumatoid arthritis (RA).Methods The proportions of apoptosis of B cells in the PB of 80 patients with RA and 80 healthy controls were measured by flow cytometry.B cells in the PB of 20 RA and 20 healthy individuals were isolated by MACS and Western blotting was used to detect the Bcl-2 and Caspase-3 protein levels.IL-17 levels were detected by enzyme-linked immunosorbent assay (ELISA).T-test and linear regression were used to analyze the data.Results The proportions of apoptosis of B cells in the PB of patients with RA and healthy controls were (14±6)％ and (24±9)％ respectively.The rate of apoptosis of B cells in patients with RA was significantly less than healthy controls (t=2.737,P=0.021).The Bcl-2 protein level of B cells in the PB of patients with RA group was significantly higher than that of control group (26±10,12±6,P＜0.01).Conversely,the Caspase-3 protein level of B cells in the PB of patients with RA group was significantly lower than that of the control group (16±7,31±12,P＜0.01).ELISA detected elevated level of serum IL-17 in the patients with RA as compared with controls [(69±19),(27±10) pg/ml,t=4.631,P=0.014].There was a negative correlation between the level of IL-17 and apoptosis of B cells in patients with RA (r=0.36,P＜0.01).Conclusion The elevated bcl-2 and reduced caspase-3 of B cells in patients with RA further proves there is abnormal apoptosis of B cells in RA patients.There is negative correlation between the expression of IL-17 and apoptosis of B cells in patients with RA and IL-17 can inhibit B cell apoptosis.

Objective To investigate the expression of helper T cells (Th)17/regulatory T cells (Treg) balance associated factors in rheumatoid arthritis (RA) patients and their correlation with serum midkine (MK).Methods A total of 60 RA patients were divided into active RA patients (n=32) and inactive RA patients group (n=28).MK level in sera was detected by enzyme linked immunosorbent assay (ELISA) in 60 patients with RA and 30 healthy controls (HCs).The fraction of CD4+CD25+FOXP3+ Treg cells and IL-17+CD4+ Th17 cells in RA patients and healthy controls were determined by flow cytometry (FCM), and the expreasion of Foxp3, RORγt, Signal transducer and activator of transcription (STAT) 3 and STAT5 mRNA were detected with real-time polymerase chain reaction (PCR).Results were evaluated using ANOVA followed by q tests for comparisons of Th17 population between active RA patients, inactive RA patients and HCs, t test was used for comparing of Foxp3, RORγt, STAT3, STAT5 mRNA between RA group and HCs.The correlations between serum MK concentration and peripheral Treg cells, Th17 cells, Foxp3, RORγt, STAT3, STAT5 mRNA were analyzed by Pearson's correlation analysis.Results The percentages of Treg cells from active RA patients, inactive RA patients and HCs were significantly different (F=129.6, P＜0.01), the percentages of Treg cells of active RA patients [(1.41±1.05)％] were lower than that of the inactive RA patients [(3.6±1.6)％;q =7.92, P＜0.05] and healthy group [(7.7±1.7)％;q=22.45, P＜0.05], and there was significant difference between healthy group and inactive RA group (q=14.53, P＜0.05).The percentages of Th17 cells of the three groups were also significantly different (F=36.3, P＜0.01),the percentage of Th17 cells of active RA patients [(1.84±1.01)％] was significantly higher than that of inactive RA patients [(0.71±0.28)％;q=9.59, P＜0.05] and healthy group (0.53±0.16)％ [(P＜0.05;q=1 1.10, P＜0.05], there was no significant difference between the inactive RA group and healthy group (q=1.51, P＞0.05).The expression of RORγt and STAT3 mRNA in RA patients was higher than that of healthy controls (t=5.84, P＜0.01;t=4.52, P＜0.01).The expression of Foxp3 and STAT5 mRNA in RA patients were lower than healthy controls (t=6.01, P＜0.01;t=2.18, P＜0.05).Serum MK values were correlated with STAT5 (r=-0.55, P＜0.01), but not with Foxp3, RORγt, STAT3 mRNA or the percentage of Treg/Th17 cells.Conclusion Serum MK expression and the percentage of Th17 cells increase, while the percentage of Treg cells decrease in RA patients.Serum MK values are negatively correlated with STAT5 mRNA which is associated with Th17/Treg balance.This may be important in the pathogenesis of RA.

Objective To explore the correlation between the cancer-related fatigue and uncertainty in illness among breast cancer inpatients. Methods Totally 90 patients with breast cancer were involved in the study by cancer fatigue scale (CRS) and Mishel's uncertainty in illness scale-adult (MUIS-A). The correlations were analyzed. Results Approximately 100.00%patients experienced fatigue during hospitalization. The total score of uncertainty in illness was 107.51 ± 21.26. There was a positive correlation between each fatigue dimension and uncertainty in illness (P<0.001). Conclusions Cancer-related fatigue is widespread among breast cancer inpatients and sense of uncertainty in illness of patients is at a moderate level. Nursing staff can help patients to reduce disease uncertainty and improve the life quality of patients by strengthening health education , providing comprehensive information support, fully mobilizing patients' social support system.

Objective To explore the value of radiomics in stratifying the Gleason score (GS) of prostate cancer based on vast image features from biparametric MRI. Methods Three hundred and sixteen patients were enrolled in this study from October, 2015 to December, 2018 and their results of surgical pathology were obtained. The lesions were manually depicted by 3D?Slicer. Then, 106?dimensional features extracted by radiomics were used to conduct Spearman non?parametric correlation test with the high and low risk stratification of GS. The constructed Neural Network was trained with the features after dimension reduction by principal component analysis as the input. Then, the testing set was fed in to get the predictive capability of the model. In the end, 10?fold cross?validation and shuffle of 100 times were used to test the accuracy of the prediction and the generalization ability of the model. Results Seventy seven?dimensional features with significant correlation were found at the level of P valued=0.05 (two?tailed). After dimensional features were reduced, 21 dimensional new feature spaces with 99% original feature information were obtained. The results on the testing data after the 10?fold validation and shuffle were AUC=0.712 with T2WI, AUC=0.689 with DWI(b=1 000 s/mm2), AUC=0.689 with DWI (b=2 000 s/mm2) and AUC=0.691 with DWI (b=3 000 s/mm2). Conclusion The neural network after extracting features from biparametric MRI images can accurately and automatically distinguish the high risk and low risk groups of Gleason grade of prostatic cancer.

Objective To summarize the preliminary clinical outcomes of combination therapy with molecular targeted agents/immunological agents and to explore the potential value of multidisciplinary therapy in the treatment of postoperative refractory recurrent hepatobiliary tumor.Methods 52 cases of postoperative refractory recurrent hepatobiliary tumor during June 2016 to January 2019 from outpatient and inpatient departments at the First Medical Center of PLA General Hospital were prospectively collected,including 37 males and 15 females,with a mean age of (56.2 ± 8.5) years.Referring to the results of next-generation sequencing (NGS) and other-omics,we designed individualized therapy options for each patient.Follow-ups were done regularly and tumor responses were assessed by modified response evaluation criteria in solid tumors (mRECIST).Results Of 52 patients,median follow-up was 10 months (range 3-31 months).14 (26.9％) patients achieved a complete response (CR).8 (15.3％) patients achieved a partial response (PR).14 (26.9％) patients had stable disease (SD).16 (30.8％,including 4 deaths) had progressive disease (PD).Objective response rate and disease control rate were 42.3％ (22/52) and 69.2％ (36/52),respectively.The median progression-free survival (PFS) was 7 months.6-and 12-month overall survival rates were 100％ (48/48),87.5％ (21/24),respectively.Conclusions Precision medicine has good guidance on the treatment of refractory recurrence of hepatobiliary tumors.The combination therapy of multi-target tyrosine kinase inhibitors and immune checkpoint inhibitors may achieve better disease control and deserve further promotion in clinical application.

Objective: To explore the value of radiomics in stratifying the Gleason score (GS) of prostate cancer based on vast image features from biparametric MRI. Methods: Three hundred and sixteen patients were enrolled in this study from October, 2015 to December, 2018 and their results of surgical pathology were obtained. The lesions were manually depicted by 3D-Slicer. Then, 106-dimensional features extracted by radiomics were used to conduct Spearman non-parametric correlation test with the high and low risk stratification of GS. The constructed Neural Network was trained with the features after dimension reduction by principal component analysis as the input. Then, the testing set was fed in to get the predictive capability of the model. In the end, 10-fold cross-validation and shuffle of 100 times were used to test the accuracy of the prediction and the generalization ability of the model. Results: Seventy seven-dimensional features with significant correlation were found at the level of P valued=0.05 (two-tailed). After dimensional features were reduced, 21 dimensional new feature spaces with 99% original feature information were obtained. The results on the testing data after the 10-fold validation and shuffle were AUC=0.712 with T₂WI, AUC=0.689 with DWI (b=1 000 s/mm²), AUC=0.689 with DWI (b=2 000 s/mm²) and AUC=0.691 with DWI (b=3 000 s/mm²). Conclusion The neural network after extracting features from biparametric MRI images can accurately and automatically distinguish the high risk and low risk groups of Gleason grade of prostatic cancer.