China has a large number of hepatocellular carcinoma patients, and more than half of the new cases and deaths of hepatocellular carcinoma in the world occur in China every year. The chemosensitivity of hepatocellular carcinoma is relatively low. Targeted therapy with antiangio-genic drugs are main treatment options for advanced hepatocellular carcinoma, but the effective rate and survival prolonging effect are very limited. Recently immune checkpoint inhibitors have exhibited promising efficacy in hepatocellular carcinoma, which is changing the pattern of hepatocellular carcinoma treatment. However, challenges still exit. Biomarkers commonly used in clinical practice including programmed death ligand-1, tumor mutational burden and mismatch repair proteins have limited clinical value in hepatocellular carcinoma. Compared with other etiology related liver cancer, hepatitis B related hepatocellular carcinoma in China harbors unique gene mutation map, but the individualized treatment strategy based on molecular typing has not yet been established. More effective and diversified systematic treatment methods can promote the comprehensive treatment of hepatocellular carcinoma into a new era, and the relevant diagnosis and treatments need to be further explored and established. Based on relevant literatures and combined with clinical practices, the authors investigate the progress and consideration of immunotherapy strategy for hepatocellular carcinoma.

Objective To study the clinical effect of minimally invasive treatment of 24 patients with hemor-rhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,ther-apeutic results of minimally invasive treatment were studied retrospectively.Results 24 patients with hemorrhagic moyamoya disease spontaneous intracerebral hematoma who need to acutely remove the hematoma were examined by CT angiography ( CTA) .Emergency minimal invasive puncture was performed according to the result of CTA,and the role of CTA in operation was analyzed.In all 24 patients,most of them were cerebral hemorrhage breaking into ventri-cles,5 cases with intracranial aneurysm.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AchA and P-CoM were observed in 9 patients,superficial temporal artery.Conclusion Minimally invasive treat-ment of hemorrhagic moyamoya disease scheme is simple,practical and effective,the maneuverability is strong.

Objective To investigate the effect of nitrotyrosine (3-NT) on the expression of ?1D adrenoceptor (?1D-AR) mRNA in cultured vascular smooth muscle cells (SMCS) .Methods SMCS were obtained from the tunica media of thoracic aorta of 1 month old SD rats and cultured in DMEM medium. The experiment consisted of two parts. In part Ⅰ SMCS were incubated with 0,1, 10, 100 or 200 ?mol?L-1 3-NT for 24 h and in part Ⅱ SMCS were incubated with 100 ?mol?L-1 3-NT forO,12, 24, 48 or 72 h. The total RNA was isolated by using Trizol reagent. The expression of ?1D-AR mRNA was determined by RT-PCR and agarose gel electrophoresis. Results In part I incubation with 1 and 10 ?mol?L- 3-NT for 24 h had no significant effect on the expression of ?1D-AR mRNA while incubation with 100 or 200 ?mol?L-1 3-NT for 24 h decreased the expression of ?1D-AR mRNA compared with 0?mol?L-1 3-NT (P

In order to explore a dose distribution verification procedure of intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and establish its evaluation criteria, we performed 35 two-dimensional (2D) patient-specific IMRT verifications over the year 2006. The percent of pixels passing gamma and the normalized agreement test (NAT) index were mainly used to represent the agreement between the measured and computed dose distributions with three criteria (2%/2 mm, 3%/3 mm and 5%/3 mm) as recommended in the literature. The results were that all cases passed through verifications with three criteria except that the NAT index of one case was beyond the limitation, and the three tolerance levels of 2%/2 mm, 3%/3 mm and 5%/3 mm produced similar clinical verification results but led to different percent of pixels passing gamma and NAT index. Our data showed that the percent of pixels passing gamma and the NAT index were complementary to evaluate future IMRT verifications as two significant metrics. Due to the influence of the noise and the trait of the software, we considered an IMRT plan as acceptable in case of the percent of pixels passing gamma >95% and the NAT index <5 with the 5%/3 mm criteria for IMRT patient-specific quality assurance (QA).

ObjectiveTo investigate the effect of a cervical back muscle trainer. MethodsA cervical back muscle trainer designed by ourself was used in 128 patients with different kinds of cervical spondylosis. The situation of pain and activity of daily life of the patients before and 1 month after treatment were recorded and compared. ResultsThe neck pain of all of the patients nearly completely disappeared in a month and their activity of daily life improved significantly(P<0.01). ConclusionThe cervical back muscle trainer can improve the stability of cervical vertebrae through increasing the strength of the cervical back muscle, which can be used as an assistant rehabilitation approach of all kinds of cervical spondylosis.

ObjectiveTo evaluate the effect of Yuxingchangzhi Decoction on level of norepinephrine (NE) and 5-hydroxyptamin (5-HT) in serum of patients with post-stroke depression. Methods76 patients with post-stroke depression were treated with Yuxingchangzhi Decoction or placebo for 4 weeks. Before and after treatment, all the patients were evaluated with the Hamilton Rating Scale for Depression (HAMD),while the level of NE and 5-HT in serum of patients were measured.ResultsThe total score of HAMD of the patients of Yuxingchangzhi Decoction group was significantly different before and after treatment (P<0.01),while that of the placebo group was not significantly different (P>0.05). The NE and 5-HT level in serum of patients of the Yuxingchangzhi Decoction group were significantly different before and after treatment (P<0.01),but that of the placebo group was not significantly different (P>0.05). ConclusionYuxingchangzhi decoction can raise NE,5-HT level in patients with post-stroke depression and alleviate symptoms of depression significantly.

Objective To screen microRNA (miRNA) that inhibit expression of the metastasisrelated gene ezrin in ovarian cancer cells and explore their correlation to the invasion and metastasis of ovarian cancer. Methods The differential expression of ezrin in two paired high-metastatic and lowmetastatic cell lines were examined by real time reverse transcription (RT)-PCR and western blot. A functional screen with microarray was employed to identify miRNA that were differentially expressed between SKOV3 and SKOV3ip cell lines. Three programs, TARGETSCAN ( http://www. targetscan. org ),MICROCOSM ( http ://www. ebi. ac. uk/enright-srv/microcosm/htdocs/targets/v5/) and PICTAR (http://www. pictar. mdc-berlin. de), were employed to identify all miRNA, which may inhibit the expression of ezrin and were differentially expressed between SKOV3 and SKOV3ip cells. To test the repressive potential of these miRNA, synthetic mimetics were transfected individually into SKOV3ip cells and endogenous ezrin expression levels monitored by western blot and real-time RT-PCR. Results ( 1 ) The mRNA average level of ezrin were (81.74 ± 5.34) -fold higher expression level in SKOV3ip versus SKOV3 cells ( P ＜ 0. 01 ), while (2. 61 ±0. 14)-fold in HO-8910PM versus HO-8910 cells (P ＜0. 01 ). Elevated protein level of ezrin were observed in SKOV3ip cells compared with that in SKOV3 cells, and the same that in HO-8910PM cells compared with HO-8910 cells. Paired SKOV3 and SKOV3ip cells were employed to study the more significant difference in ezrin expression between them. (2) By a functional screen using miRNA microarray combined with bioinformatics analysis,the miR-183 and miR-22 were indentified as two candidate miRNA,which may have the potential regulatory role in ezrin expression. Real time RT-PCR assays revealed that miR-183 and miR-22 were, respectively, an average of (5.84 ± 0.66)-fold and(6.67 ± 0.67)-fold higher expression level in SKOV3ip versus SKOV3 cells (P ＜0. 01 ), which were in agreement with the microarray data. A subsequent validation by western blot and real time RT-PCR revealed that over-expression of miR-183 and miR-22 could both lead to an obvious decrease in ezrin protein level,while there were not signicant difference in the level of ezrin mRNA( P ＞0. 05 ). Conclusion Increased expression of miR-183 and miR-22 may both repress the protein level of ezrin,indicating that miR-183 and miR-22 may bear a potential role in inhibiting ovarian cancer metastasis in a ezrin-mediated way.

Objective To explore the correlation factors for surgical treatment in lumbar spinal tuberculosis.Methods A total of 46 patients with lumbar spinal tuberculosis who underwent surgical treatment were analyzed.The possible correlation between the clinicopathologic features and clinical outcome were analyzed by Logistic regression analysis.Results Nine patients failed in surgical treatment.Multiple analysis showed that the number of infected vertebrae (OR =6.44,95％ CI:2.47-19.92) and internal fixation (OR =10.76,95％ CI:3.50-18.74) had significant correlation with the clinical outcome.Conclusions Surgical treatment for lumbar spinal tuberculosis has a favorable outcome in patients.The number of infected vertebrae and internal fixation are significant risk factors for poor outcome.

Objective:To investigate the preemptive analgesic effect of flurbiprofen on inflammatory cytokine in patients undergoing cerebral operation.Methods:Forty ASA Ⅰ-Ⅱpatients undergoing cerebral surgery were randomly divided into control group(group C,n=20)and flurbiprofen group(group F,n=20).Flurbipmfen of 10 mL was given intravenously 15 min before skin incision.The values of VAS scores were recorded at 2 h,24 h and 48 h after operation.Blood samples were taken for determination of serum levels of TNF-α,IL-6 and IL-10 immediately before induction of anesthesia(T1,baseline),at 2 h of operation (T2),immediately after the end of operation (T3) and 24 h after operation (T4).The parameters of anaesthesia time,hemorrhage volume,urine volume,transfusion volume and the dosage of remifentanil and propofol were recorded during the period of anaesthesia.Results:The VAS score was lower in group F than that in group C at 2 h and 24 h after operation (P＜0.05),but there was no difference at 48 h after operation between the two groups(P＞0.05).The dosages of remifentanil and propofol were lower during anaesthesia in group F than that in group C(P＜0.05).Compared with T1,TNF-α was significantly increased at T2 and T3 in both groups,and the peak value at T2 (P＜0.05).TNF-α was decreased at T2-T4 in group F than that in group C(P＜0.05).Compared with T1,the levels of IL-6 and IL-10 were significantly increased at T2-T4 in both groups,and the peak value at T3(P＜O.05).The value of IL-6 was decreased and the value of IL-10 was increased at T2-T4 in group F than those in group C (P＜0.05).Conclusion:Flurbiprofen was suitable as a preemptive analgesia and could suppress stress reaction of inflammatory in neurosurgery.