Alpha fetoprotein(AFP) plays multi-role in regulating the growth of hepatocellular carcinoma cells, because of AFP has a complex molecular structure. AFP not only can promote the proliferation of hepatoma cells, but also can inhibit the immune response in liver cancer patients. Recently, documents showed that AFP has a capability to impair the function of dentritic cells(DCs), and AFP could induce DCs to death. AFP restrain DCs transform to matured antigen presenting cell through regulating the phenotype molecule express in the membrane of DCs, and AFP also influence the expression of tumor necrosis factor family and its receptor in lymphocytes or in hepatoma cells, AFP also could inhibit the activity of caspase in tumor cells, possesses these effects of AFP result in the hepatoma cells escape the immune surveillance.

Objective To investigate the application value of transvaginal three-dimensional ultrasound combined with tomographic ultrasound imaging (TUI) in the diagnosis of early ectopic pregnancy. Methods One hundred and twenty patients with 4 to 6 weeks menopause were collected. All of the cases were clinical suspected of ectopic pregnancy and the surgical pathology and clinical follow-up results of each case were obtained. Both transvaginal two dimensional ultrasound imaging and three-dimensional ultrasound imaging combined with TUI technique were applied in order to make a diagnosis based on ultrasonographic characteristics for each of the case;surgical pathology and clinical follow-up results were compared with the ultrasonographic diagnosis so as to analysis and conclude the ultrasonographic imaging characteristics of cases misdiagnosed or missed diagnosed by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI technique. Results One hundred and two cases were confirmed as ectopic pregnancy by surgical pathology and clinical follow-up results among 120 patients and eighteenth cases were confirmed as intrauterine pregnancy. Comparing surgical pathology and clinical follow-up results with the ultrasonographic diagnosis showed:(1) Ninety-two cases of tubal pregnancy:80 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (86.9%, 80/92) while 84 cases by three-dimensional combined with TUI technique (91.3%, 84/92); 8 cases were missed diagnosed by both two methods;4 cases were misdiagnosed by transvaginal two-dimensional ultrasound imaging while zero case by three-dimensional combined with TUI technique. Ultrasonographic imaging characteristics:adnexal masses presented as“Donut”sign which was similar to gestational-sac or masses with irregular boundary. The majority of the masses presented as clear boundaries and internal structure and had obvious margins with fallopian tube. A total 36 cases of unruptured tubal pregnancy were correctly diagnosed by the two methods while 43 cases of abortion type and 5 cases of ruptured type were correctly diagnosed. (2) Ten cases of uterine cornual pregnancy:6 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (60.0%, 6/10) while 9 cases by three-dimensional ultrasound imaging joint TUI technique (90.0%, 9/10);4 cases were misdiagnosd by transvaginal two-dimensional ultrasound imaging and 1 case by three-dimensional ultrasound imaging joint TUI technique. Ultrasonographic imaging characteristics:the gestational-sac was located in the uterine horn, 6 cases of gestational-sac was not connected with endometrium showed by transvaginal two-dimensional ultrasound imaging while 9 cases were clearly showed by three-dimensional ultrasound imaging joint TUI technique that the gestational-sac was connected with endometrium, especially in the coronal-section. The surrounding decidua circumvoluted the gestational-sac was unclear in 4 cases by transvaginal two-dimensional ultrasound imaging and in 9 cases by three-dimensional ultrasound imaging joint TUI technique. And‘interstitial line’ sign appeared in 4 cases showed by transvaginal two-dimensional ultrasound imagingwhile 6 cases by three-dimensional ultrasound imaging joint TUI technique. (3) Cases missed diagnosed and misdiagnosed:8 cases of early ectopic pregnancy were missed diagnosed both by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI. The reasons we concluded were as follow:‘false gestational-sac’ located in the uterine cavity;the location of the gestational-sac was so closed to uterine cavity. Four cases of tubal pregnancy and 4 cases of uterine cornual pregnancy were misdiagnosed by transvaginal two-dimensional ultrasound imaging. The location of the ectopic pregnancy mass and the gestational-sac of 7 cases of uterine cornual pregnancy were clearly showed by three-dimensional ultrasound imaging joint TUI and only 1 case was misdiagnosed. Conclusions Transvaginal three-dimensional ultrasound imaging combined with TUI technique can provide more detailed ultrasound diagnostic information and reduced missed diagnosis and misdiagnosis of the early ectopic pregnancy. The clinical application value of transvaginal three-dimensional ultrasound imaging combined with TUI technique in the diagnosis of early ectopic pregnancy was good.

Objective To investigate the reproducibility and consistency in contouring parotid gland volume based on computed tomography (CT) and magnetic resonance (MR) images in patients with nasopharyngeal carcinoma during radiotherapy.Methods Twenty-seven patients with nasopharyngeal cancer in Shandong Cancer Hospital from December 2012 to May 2013 were randomly enrolled and underwent intensified CT and MR imaging before radiotherapy.The parotid gland were contoured with unified standard on both CT and T1-MR images by 11 radiotherapists.Specifically,one radiotherapist sketched the parotid gland on CT and MR images for ten times as intra-group comparison,the other ten were asked to sketch the parotid gland on CT and MR images only once as inter-group comparison.The intra-and inter-group's variations of parotid gland volumes were analysed.Results The average volumes of intra-group on CT and MR images were (33.8 ±9.4) cm3(L),(33.2±7.6) cm3(R) and (24.4 ±7.6) cm3(L),(22.5 ±7.4) cm3(R).As well,for inter-group the average volumes were (34.6 ± 12.1) cm3 (L),(34.3 ± 9.0) cm3 (R) and (24.6 ± 7.6) cm3 (L),(23.2 ± 8.1) cm3(R),respectively.The volume variable ratios on CT images were (6.8 ± 1.5)％ (L),(6.3 ± 1.5) ％ (R) for intra-group and (18.0 ± 4.8) ％ (L),(17.4 ± 4.6) ％ (R) for inter-group.Similarly,the intra-and inter-group ratios for contouring on MR images reached (2.3 ±0.4)％ (L),(2.1 ±0.7)％ (R) and (4.7 ±0.7)％ (L),(5.0±0.6)％ (R),respectively.Conclusion Parotid gland contouring based on MR images has a better reproducibility and consistency than that based on CT images.It is beneficial to get a more objective and true indicator to estimate the radiation injury of parotid gland.

OBJECTIVE:To provide basis and thinking for the development of medicines for treating depression. METHODS:Rats with adaptive feeding for 7 d were randomly divided into normal group,depression group and treatment group(citalopram hy-drobromide 1 mg/kg),8 in each group. Rats in depression group and treatment groups randomly received once low-density stimula-tion in a day [catching tail stimulation(1 min),frequent flashing stimulation(120 times/min,12 h),noise stimulation(4 h),ice water swimming stimulation(1 h),hot water stimulation(45 ℃,1 h),electric shocking foot(10 Hz,1 mA,each time interval of 100 ms,100 times),no food and no water(24 h)] for 21 d to reduce stress depression model. Body mass of rats in 0,7 d of adaptive feeding and 7,14,21 d of stress were respectively weighed,and horizontal activity and vertical activity frequencies in open field test were detected. After stress,rats were intragastrically administrated related medicines for 30 d,then 5-hydroxytrypta-mine (5-HT) and tryptophan hydroxylase (TPH) expressions in brain,liver,kidney tissues were determined. RESULTS:Com-pared with normal group,the increasing trend of body mass in depression group and treatment group slowed down from the 14 d of stress(P<0.05). The horizontal activity frequencies in depression group and treatment group in 14,21 d of stress slowed more ob-viously than the previous time point (P<0.05 or P<0.01);vertical activity frequencies in 21 d of stress slowed more obviously than the previous time point (P<0.05 or P<0.01). After 30 d of administration,horizontal activity and vertical activity frequen-cies in treatment group were increased more obviously than the previous time point (P<0.01). Compared with depression group,brain tissue of rats,indicating that TPH can be used as a target for depression treatment.

With the in-depth study of alpha-fetoprotein (AFP) and lymphocyte immune regulation, tumor suppressor protein factor and stem cell factor, it is found that AFP is involved in tumorigenesis, growth, metastasis and maintenance of liver cancer cell stem cell function. AFP inhibits natural killer cell activity by inhibiting lymphatic system to protect the liver cancer cells from immune surveillance; AFP can also inhibit the activity of tumor suppressor genes such as caspase-3, pten, p53 and tumor suppressor proteins; AFP can promote the formation of liver cancer stem cells and maintains stability through activating the expressions of other cancer stem cells factors. This paper reviews the biological functions of AFP by regulating hepatocellular carcinoma cells to evade immune surveillance, inhibiting apoptosis and maintaining the generation of liver cancer stem cells.

Gallbladder carcinoma(GBC)is one of the most common malignant tumors in the biliary system,which is difficult to diagnose in the early stage due to its high degree of malignancy,invasiveness and lack of specific clin-ical manifestations.In this paper,we summarize ultrasound,CT and other imaging manifestations in the early stage of GBC,and describe the role of protein markers and microRNA marker as biomarkers in the diagnosis of early GBC.The enhanced understanding of the relevant features might help to improve the accuracy of the diagnosis of early gallbladder carcinoma.