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.

Objective To probe into the quantizing rule of the thoracic vertebra rotation.Methods6 healthy corpses specimen were fixed on a wooden apparatus and rotated from 0° to 90° for X-ray examination.A X-ray examination was taken at each 5° rotational point.The characteristic of the image at each examinational point was observed.ResultsThere was radiology characteristic at each rotational point.ConclusionThe thoracic vertebra rotational degree could be quantized by X-ray examinations.

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 investigate the prognostic factors of sorafenib treatment in patients with advanced hepatocellular carcinoma (HCC) underwent surgical therapy or transcatheter arterial chemoembolization (TACE).Methods 62 patients with advanced HCC underwent surgical therapy or TACE were post-treated with sorafenib (400mg,bid).The overall survival (OS) and progress-free survival (PFS) were evaluated by Kaplan-Meier method.Results There were 30 patients in surgical group and 32 patients in TACE group.The median OS in surgical group and TACE group were 12.2 and 5.7 months (P =0.019) and the median PFS were 16.7 and 10.6 months (P =0.033),respectively.The liver cancer volume / liver volume ＞50 ％ and Child-Pugh classification were independent risk factors for PFS in surgical group,the Child-Pugh classification and vascular invasion were independent risk factors for OS in surgical group.Conclusion The patients' PFS and OS in surgical group by oral sorafenib are better than those of patients in TACE group.The effective ways to prolong the PFS include decreasing volume of liver cancer and the better liver function.

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.