Cancer cells can change metabolic pathways, including glycolysis and glutamine metabolism, and produce the raw materials needed for rapid proliferation and survival. Therefore, research on metabolic pathways of cancer cells might help find the targets of cancer therapy. In this review, we outlined the metabolic features of aerobic glycolysis, glutamine metabolism and (tricarboxylic acid) TCA cycle in cancer. We also described metabolic targets for cancer therapy and therapeutic agents for the corresponding targets in these metabolic pathways, and finally discussed some of the challenges related to tumor metabolism as a therapeutic target in cancer therapy.

Objective To study the correlation of artery stiffness with left ventricular remodeling and cardiac function in coronary heart disease (CHD) patients .Methods Four hundred and eighty patients were divided into CHD group (n=373) and non-CHD group(n=107)according to their coronary angiography .Patients in CHD group were further divided into normal left ventricular re-modeling group (n=139) and abnormal left ventricular remodeling group (n=243) .Their brachi-al-ankle pulse wave velocity (BaPWV ) was measured .The patients underwent echocardiography and 42 patients in CHD group received Doppler tissue imaging .Results The BaPWV was signifi-cantly higher in CHD group than in non-CHD group (P<0 .01) and in abnormal left ventricular remodeling group than in normal left ventricular remodeling group (1689 ± 305 cm/s vs 1508 ± 280 cm/s ,P< 0 .05) .The BaPWV was positively related with the IVST ,PWT ,RWT ,LVMI ,E/Ea and negatively related with the LVEF ,Ea ,Ea/Aa in CHD group (P<0 .05 ,P<0 .01) .Partial cor-relation analysis showed that the BaPWV was significantly related with the IVST ,PWT ,RWT , LVMI ,LVEF ,Ea ,Ea/Aa and E/Ea when the effect of hypertension ,etc ,was excluded (P<0.01) .Multivariate regression analysis demonstrated that the BaPWV was an independent factor for LVMI and LVEF .Conclusion BaPWV is an independent factor for left ventricular remodeling and cardiac function in CHD patients .

Objective To know the progress of research in oral care of orotracheal intubated patients in China and to analyze the existing problems as well as provide the reference for further study.Methods Databases of CNKI,Wanfang,VIP and CBM were searched for literature on oral care for the orotracheal intubated patients by the end of December 2013,and the methods of bibliometrics were used to analyze the research results.Results Three hundred and nine articles that met the inclusion and exclusion criteria from 1997 to 2013 were collected.These papers were mainly included in 22 kinds of nursing journals.The methods of oral care for orotracheal intubated patients could be classified into five types:rinse and swabbing (95 papers),traditional cotton(cotton swab) cleaning or gauze swabbing (58 papers),toothbrushing (54 papers),oral rinse (51 papers),laryngoscope assistance (7 papers).With 54 articles using traditional cotton balls as oral care tool,55 papers using toothbrush,including children toothbrush of soft bristle (29 papers),ordinary toothbrush (14 papers) and electric toothbrush (12 papers).Oral care solution mainly included normal saline(49 papers),traditional Chinese medicine (36 papers),chlorhexidine(36 papers),antibiotics (12 papers),povidone iodine (17 papers),sodium bicarbonate (9 papers),etc.Conclusions The oral care of orotracheal intubated patients has attracted the attention of researchers,but the use of oral care methods,the frequency in oral care and oral care tools still owe specification.More attention should be paid to strengthen the training of nursing staff,to improve the scientific research ability of scientific research workers and to carry out large sample and high quality trials.An oral care guideline that fits into our national conditions should be built in an effort to improve the level of oral care in critical patients in our country.

Objective To study the effect of liver transplantation using right liver lobe Ⅴ and Ⅷ segments with middle hepatic vein(MHV) and without main MHV on the regeneration of liver transplantation. Methods 25 pair of donors and receptors of liver transplantation were divided in to two groups:with M HV group (group A, n= 14) and without main MHV (group B, n=11). The volumes of Ⅴ and Ⅷ segments of liver were measured in donors presurgicaUy,half month and 3 month in receptors postsurgically, the rates of regeneration of the Ⅴ and Ⅷ segment were calculated half month and 3 months postsurgically and compared between two groups. Results In group A,the regenerate rates of the Ⅴ,Ⅷ segment were 0.360±0.043 and 0.853±0.059 half month after surgery,0.253±0.043 and 0.708±0.059 three months after surgery respectively. In group B, the regenerate rates of the Ⅴ,Ⅷ segment were 0.306±0.049 and 0.815±0.066, respectively half month after graft, 0.161±0.049 and 0.627±0.066, respectively three months after surgery. There were no statistically significant differences in regenerate rates of the Ⅴ, Ⅷ segment of graft be-tween the two groups (P= 0.685 ,P>0.05 and P= 0.738, P>0.05). Conclusion The right lobe living donor liver transplantation, maintaining the MHV or reconstruct MHV tributaries without MHV has similar effects on the regeneration of Ⅴ,Ⅷ segment of graft.

Objective To investigate the expression of aquaporin-3 (AQP3) in tongue tissues of rats with experimental severe acute pancreatitis (SAP) and regulating effects of emodin. Methods Rat models with SAP were established by injecting 5% sodium taurocholate retrogradely into gallbladder and pancreas. SD male rats were randomly divided into sham-operation group, model group, and emodin group. After model establishment, rats in the emodin group received gavage with emodin 20 mg/kg each day, while rats in the model group and sham-operation group received gavage with normal saline. The mental state, thick greasy tongue fur and mortality of rats were observed every day after model establishment, and 5 days later, protein and genetic expression of AQP3 were detected by Western blot and RT-PCR. Results Compared with the model group, the mortality and the thick greasy tongue fur significantly decreased, the protein and genetic expression of AQP3 significantly decreased in the emodin group (P<0.05). On the 5th day, 11 rats in the model group survived, and 5 rats had thick greasy tongue fur. Compared with the sham-operation group, the protein and genetic expression of AQP3 in the model group were higher (P<0.05). Conclusion Emodin can improve the severity of SAP and decrease the incidence of thick greasy tongue fur significantly by reducing the protein and genetic expression of AQP3.

Objective To detect the expression of tumor‐associated macrophages(TAM) in esophageal squamous cell carci‐noma ,and to study the clinical pathological characteristics of T AM in the esophageal squamous cell carcinoma .Methods Patients with esophageal squamous cell carcinoma who accepted operation were chosen as study subjects ,and tissue samples of esophagus were collected ,including 90 squamous cell carcinoma tissues ,20 paracancerous atypical hyperplasia and 20 normal mucosa tissues , and the expression of CD206 ,MCP‐1 were detected by immunohistochemisty .Results The positive expression of CD206 was sig‐nificantly increased in tissues of esophageal squamous cell carcinoma (P<0 .01) ,and it was positively correlated with clinical stage , invasion depth and lymph node metastasis in esophageal squamous cell carcinoma (P<0 .05) .The expression of MCP‐1 was signifi‐cantly increased in esophageal squamous carcinoma tissues (P<0 .05) ,and its positive expression was closely correlated with depth of invasion and lymph node metastasis in esophageal squamous cell carcinoma (P< 0 .05) .There was a positive relation between ATM infiltration quantity and the expression of MCP‐1(r=0 .617 ,P<0 .05) .Conclusion The positive expression of TAM was up‐regulated in esophageal squamous cell carcinoma tissues ,and its number was positively correlated with clinical stage ,invasion depth and lymph node metastasis .

Objective To evaluate the accuracy of multi-detector spiral CT (MSCT) semiautomated volumetric measurement of right lobes and its value in living donor liver transplantation (LDLT). Methods Fifty-six donors underwent four phases MSCT. Pre-operative liver volumes of two measurements [IQQA(R)-liver semi-automated (Vs) and manual volume (Vm) measurements] in portal vein phase were compared with intra-operative measurement (Vio) by means of water displacement. Results Correlation analysis and Bland-Altman tests were used for statistical analysis.Results Pre-operative measurements of grafts resulted in a mean Vs, Vm, Vio of (818. 60 ± 161.43)cm3 , (880. 16 ± 169. 92) cm3 and (669. 84 ± 141.37) cm3 respectively. All corresponding pre-and intra-operative data were correlated significantly with each other. There was a good correlation between Vs and Vio(r= 0. 778, P＜0. 05), so did Vm and Vio(r= 0. 746, P＜0. 05). The equations of linear regression were Vio = Vs × 0. 681 + 112. 26, and Vio = Vm × 0. 620 + 123. 81 respectively. Exact 95 % CIs and the extent of concordance were 121.57-175. 95 cm3, -354. 135-56. 62 cm3 for semiautomated measurements, and 180. 09-240. 56 cm3 , - 438. 66-18. 01 cm3 for manual measurements,respectively. Conclusion Semi-automated method for the volumetric measurements of the right liver lobes in LDLT is more accurate than the manual method.

Objective To systemically evaluate the accuracy of CT and MR estimating whole liver volume with evidence based medicine methods.Method Published papers about whole liver volume estimation with CT or MR modality were searched in Cochrane library,MEDLINE,EMBASE,CMBdisc(China biology medicine disc) for English and Chinese abstracts.Inclusion criteria were formulated according to validity criteria for diagnostic research published by the Cochrane collaboration.Heterogeneity test of extracted data of Eligible papers was performed first to determine the appropriate statistical model used to pool the result.Finally,sensitivity and publish bias analysis was performed.Result Seventeen articles with 37 studies including 351 patients met the inclusion criteria.There was no heterogeneity between included studies (I2 =0％,Q =5.85,P =1).Fixed effect model was selected for the meta analysis and there was no statistically significant difference between true and radiological estimated whole liver volume (WMD =21.61 mL,95％ confidence interval:-6.33-49.57 mL,z =1.51,P =0.13).Sensitivity analysis revealed the result was robust which was not affected by excluding any of the included studies.Funnel plot and publish bias analysis showed no publish bias (t =-1.55,P=0.13).Conclusion CT and MR volume estimation is accurate for liver volume measurement,which provides important information for preoperative evaluation,postoperative monitoring and follow-up studies of other hepatic pathologies.aximum benefit to patients.

Objective To investigate the feasibility of magnetic resonance diffusion tensor imaging (DTI) as a noninvasive way for assessment of kidney transplant function in the early posttransplantation period.Method Fifty-one kidney transplant recipients less than 1 month after kidney transplantation and 26 age-matched healthy volunteers were included and examined using a fatsaturated echo-planar DTI sequence in oblique-coronal orientation at 3.0 Tesla magnetic resonance (MR) imager (diffusion directions=6,b =0,300 s/mm2).According to the estimated glomerular filtration rate (eGFR) recorded and calculated on the examined day,all subjects were divided into four groups:group 1,healthy volunteers (n =26) ; group 2,eGFR≥60 mL/min/1.73 m2 (n =24) ; group 3,30≤eGFR＜60 mL/min/1.73 m2 (n =19) ; group 4,eGFR＜30 mL/min/1.73 m2 (n =8).Mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) were determined separately for the cortex and the medulla.The paired Students t test was used to compare ADC and FA between cortex and medulla within each group.ADC and FA between groups were compared by using the one-way analysis of variance test.Relationship between ADC and FA with eGFR of the transplants was assessed by using Pearson correlation analysis.Result Mean cortical FA was significantly higher in group 1 than in other three groups (P＜0.01 for all),while differences among groups of allograft recipients were not significant (P＞0.05 for all).There was a gradually decreasing trend of medullary FA and ADC,and cortical ADC from group 2 to group 4,and the differences among groups were all pronounced (P＜0.05 for all).In renal allografts,there was a significant positive correlation between eGFR and medullary FA,medullary ADC as well as cortical ADC (r =0.812,0.756,0.757,respectively,P＜0.01).The cortical-medullary discrimination of FA-map and ADC-map in group 3 and group 4 apparently decreased.Meanwhile,DTI revealed that the radial diffusion tracts in the medulla of group 3 and group 4 obviously broke off and reduced,especially in group 4.Conclusion DTI is a promising way to evaluate kidney transplant function early after transplantion,and can quantitatively and visually distinguish transplants with different functions.

Objective To summarize the diagnostic efficacy of ADC value for differentiation of benign and malignant lymph nodes on diffusion MRI with Meta-analysis. Methods Published papers on differentiation of benign and malignant lymph nodes with ADC value were searched and reviewed.Quality evaluation was performed for the eligible papers before data extraction.Test for heterogeneity was performed first,then appropriate model was selected to calculate the weighted mean difference,sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,pretest and posttest probability.The potential of ADC value for differentiation of benign and malignant lymph nodes was assessed qualitatively and quantitatively.Results Fifteen papers including 735 cases and 1963 lymph nodes were selected.According to Meta-regression analysis,subgroup analysis and robust analysis,two studies with benign lymph nodes in patients with benign lesion and one study using chemical shift saturation technique were excluded because of their impact on the robustness of the pooled results. The weighted mean difference (WMD) between malignant and benign lymph nodes was -0.355 × 10-3mm2/s[95％ confidence interval (CI):-0.423 ×10-3- -0.288 × 10-3 mm2/s].Although the cutoff of ADC value for differentiation in each study was different,the diagnostic efficacy was stable,the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and area under summarized receiver operator's curve were 0.87 (95％ CI:0.79-0.92),0.87 (95％ CI:0.82-0.90),6.5 (95％ CI:4.7-9.2),0.15 (95％ CI:0.09-0.25 ),43 ( 95％ CI:21-87 ),0.93 ( 95 ％ CI:0.90-0.95 ).The posttest malignancy probability of benign lymph node indicated by ADC was 6％,while that of malignant lymph node was 72％.Conclusion The ADC value can be used to differentiate benign and malignant lymph nodes with good sensitivity and specificity noninvasively.