Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) preferentially induces apoptosis in tumor cells but not in normal cells. It induces apoptosis in its target cells by interacting with surface death receptors DR4 and DR5,which contain a cytoplasmic region designated as thedeath domain. Clinical use of rhTRAIL and its agonistic antibodies is limited due to partial or completetolerance to TRAIL in human tumor cell lines. As TRAIL binding to its death receptors is the initial and crucial step in initiating apoptosis, the mechanisms of TRAIL-tolerance in tumor cells is closely related to the expression,location,distribution and function of TRAIL receptors . Personalized care combined with other therapies targeting TRAIL receptors may be expected to overcome the TRAIL-tolerance of tumor cells eventually.

Pancreatic cancer with liver metastases (PCLM) is a refractory malignant tumor characterized by insidious onset, rap-id progress, and poor prognosis. Only a few patients had the opportunity of receiving surgical treatment. PCLM is primarily treated by systemic chemotherapy. The chemotherapeutic regimen of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin has become the first-line therapy for PCLM patients with good performance status. Gemcitabine-based chemotherapy is still very important in treating PCLM. Nab-paclitaxel plus gemcitabine, which has been found to increase survival, is recommended as a new standard for treating PCLM patients. However, still no breakthrough has been established in the study of gemcitabine plus molecular-targeted therapy. Sys-temic chemotherapy combined with trans-catheter arterial chemoembolization is valuable and may be effectual in prolonging survival. Further investigation of prospective and randomized controlled clinical trials is necessary. Radio frequency ablation and brachy-thera-peutic embolization with yttrium-90 microspheres are still in the exploratory stage. Multimodality treatment of PCLM using chemother-apy, radiation therapy, and Chinese herbal medicine is gaining wide acceptance. This article reviews the recent progress in the treatment of PCLM.

AlM:To discuss the clinical effect and safety of the combined surgeries of phacoemulsification and goniosynechialysis for patients with primary angle -closure glaucoma ( PACG) .METHODS:Eighty-three eyes of 83 patients with PACG and cataract were ranomized into two groups. Group A:39 patients with 39 eyes of angle-closure <180.;Group B:44 patients with 44 eyes angle - closure ≥180.. The changes of visual acuity, anterior chamber depth ( ACD) , anterior chamber angle and lOP after operation were measured. The follow-up period was for 1a.RESULTS: The visual acuity was improved significantly in both group after operation. No significantly difference in ACD, anterior chamber angle after operation in two groups (P>0. 05). The lOP in group A was lower than that in group B 3mo after operation, there was statistical significance (P<0. 05).CONCLUSlON:Phacoemulsification and goniosynechialysis can deepen ACD significantly. This method make the anterior chamber angle open, can reduce lOP and improve the patients’ visual acuity, especially in patients with PACG. lt is a safe and effective approach to patients with PACG and cataract.

The present article introduced the standards of moldproof test and their application in detail, expatiated on the harmful effect of the mold on industrial materials or products and the requirements of selecting the experiment parameters, discussed the limitation of the standards for moldproof test used in China.

Objective To evaluate the heating ability of thermoseeds in alternating magnetic field and its therapeutic effects on tumor bearing rats with simultaneously detected immune function. Methods To monitor the temperature increase of thermoseeds in vitro,of which the Curie point was 57 ℃ or 70 ℃.Forty Wistar rats implanted with Walker-256 cells were randomly divided into five groups: C group(control group,10 rats),M group(magnetic control group,5 rats),T group(thermoseeds control group,5 rats) and two heating treatment groups(H1 group,10 rats and H2 group,10 rats).In the H1 group,two thermoseeds with a Curie point at 57 ℃ were implanted into the tumor tissues in each rat with a heating time of 30 minutes,while in the H2 group,two thermoseeds with a Curie point at 70 ℃ were used with a heating time of 6 minutes.Five rats from each group were killed 9 days after the heating therapy to evaluate the volume and weight of the tumor tissues.The peripheral blood T-cells were counted in the rest rats in the H1,H2,and C groups. Results Magnetic inductive heating of the thermoseeds in vitro can reach the Curie point.The median tumor volume in the H2 group was 0.50 cm3(0.00-26.54),which was significantly lower than that in the M group(36.18 cm3,0.96-39.90,Z=2.21,P=0.032).And the weight of the tumors in the H1 and H2 groups was significantly lower than that in the M group [0.96 g(0.00-21.18) in H1 and 0.41 g(0.00-23.40) in H2 vs 31.45 g(1.09-36.09) in M group,Z=2.21 and P=0.032 for both].In the peripheral blood,the percentage of CD4+ T-cells was(22.39?5.27)% in H1 group,and(24.76?5.19)% in H2 group,which were significantly higher than that in C group [(12.07?4.45)%,P=0.01 and 0.003 respectively];and the percentage of CD8+ T-cells in the H2 group was significantly higher than that in the C group [(19.58?4.63)% vs(12.72?3.96)%,P=0.04].Conclusions Thermoseed had a good heating ability in alternating magnetic field and its inductive heating can inhibit tumor growth in Wistar rats and improve the immune function of the rats.

Mycotoxins are secondary metabolites produced by certain genera of toxigenic fungus and frequently oc-cur in food worldwide. Humans and animals can be simultaneously exposed to different mycotoxins through the diet. As most mycotoxins are highly toxic, carcinogenic, teratogenic and mutagenic, they have posed grave health threats to consumers. Determination of mycotoxins and their main metabolites in blood, urine, bile, milk or faeces can serve as biomarkers and can facilitate effective exposure assessment, crucial to estimate mycotoxin related dis-ease risk. According to reason mentioned above, the study of metabolism and evaluations of mycotoxins in biologi-cal fluids have been paid increasing attention since the results may offer valuable indications on the real risk for consumers. Therefore, it is important to develop proper analytical methods for the rapid quantitative and qualita-tive measurement of mycotoxins and key metabolites in vivo. This paper reviewed some biomarkers and their harm to animals and humans, systematically summarized the research progress of analytical methods and prospected the development trends.

Objective To investigate the clinical value of the decfion of percentage of pulmonary perfusion defect score (PPDS％) in patients with pulmonary embolism (PE).Methods A retrospective study was carried out on PPDs％ data of patients(n =36) with clinical confirmed PE.The patients were divided into three levels:low (PPDS％ ＜30％),medial (30％ ≤PPDS％ ＜50％) and high (PPDS％ ≥50％) risk groups,according to the standard of PPDs％ diagnosis.the PPDS％ and the incidence rate of the clinical adverse events were compared in mild,moderate and severe risk PE.The therapeutic results were compared with the PPDS％ changes.Results The mild,moderate and severe risk patients with PE were 15 cases,13 cases and 8 cases respectively,according to the standard of PPDS％ diagnosis.16 cases,12 cases and 8 cases respectively,according to the standard of 2008 ESC APE diagnosis and treatment guidelines.The uniform rate was 94.4％ for two methods,the uniform rate was 100.0％ in which high risk of PE.The PPDS％ of PE was (46.2 ± 4.6) ％ before treatment.The data was significantly higher than that post treatment (31.6％ ± 1.8％) (t =17.38,P ＜ 0.01).The scores of low,medial and high risk patients were (25.9 ± 3.9) ％,(45.6 ± 4.3) ％ and (58.4 ± 4.9) ％ (t =6.18,P ＜ 0.01),respectively.The mild,moderate and severe risk PE according to the PPDS％ standard with clinical adverse events for were 1 cases (6.5％),3 cases (23.0％) and 5 cases (62.5 ％) respectively,with a significant difference (x2 =8.71,P ＜ 0.05).Conclusion PPDS％ could be used as an important reference index for risk stratification of diagnosis,evaluating therapeutic efficiency and predicting the prognosis in patients with PE.

Objective To explore the predictive value of response to neoadjuvant chemotherapy(NAC)in local advanced breast cancer with contrast-enhanced ultrasound(CEUS)of axillary lymph node.Methods CEUS of metastatic axillary lymph nodes in 58 patients stacng Ⅱ-Ⅲ breast cancer was performed before and after NAC treatment. The enhancement patterns and parameters of time-intensity curve were assessed and compared with the pathology.Results The clinic response evaluation were drug-effective in 35 cases and no change in 23 ones.There Were no significant differences in enhancement patterns between no-change and drugeffective groups.Lymph node cortex arriving time was longer in drug-effective cases than that in no-change ones after NAC,whereas it showed no significant differences before NAC.Statistical significant difierence in enhancement duration(ED)was found between the two groups before NAC,which decreased markedly in drug-effective case8 after NAC.Histopatholngic response could be predicted with a sensitivity of 77% and a specificity of 90% by standardized ED below 275 seconds after NAC.No significant difference was found in time to peak(TP),peak intensity(PI)between the two groups.Conclusion The perfusion pattern of axillary lymph node CEUS after NAC Was insufficient to predict curative effect.But the lymph node cortex arriving time and enhancement duration may be of value in the prediction of clinical response to chemotherapy.

Objective Toinvestigatetherelationbetweenserumneuron-specificenolase(NSE), bilirubinandcerebraldysfunction,prognosisafterlarge-arteryatheroscleroticstroke.Methods According to the Trial of Org 10172 in Acute Stroke Treatment (TOAST)criteria,all the 73 patients with large artery atherosclerotic stroke were divided into the test group (41 cases ) and control group (32 cases ) according to the elevated or normal levels of serum NSE and total bilirubin. At the first day of their hospitalization,the National Institutes of Health Stroke Scale (NIHSS)score was conducted,their serum NSE,bilirubin (total bilirubin,direct bilirubin,indirect bilirubin)levels were detected,and were compared with the reevaluation of 7 and 14 days of their hospitalization and reexamination results. The modified Rankin Scale (mRS)was use to assess the recovery of their neurological function at day 30 after onset/admission. The prognosis of the patients was followed up at 1 year after onset/admission. The Kaplan-Meier product-limit method was used to conduct the analysis of the good outcome rate,and the good outcomes of both groups/interlayers (different bilirubin and NSE levels)were tested with Log-rank test. Results (1)The NIHSS scores,the levels of serum bilirubin and NSE at day 1,7,and 14 in the test group were significantly higher than those of a control group (all P<0. 01). The levels of serum bilirubin and NSE at day 7 and 14 were lower than those at day 1. (2)The mRS score at day 30 between the test group and the control group was singnificantly different (Z =3. 286,P =0. 001). (3)At day 1,the CT detection rate of large area cerebral infarction of the test group was significantly higher than that of the control group (56. 1%[n=23]vs. 28. 1%[n=9]). There was significant difference (χ2 =5. 712,P=0. 017). (4)The analysis result of Kaplan-Meier showed that there was no significant difference in its good outcome no matter grouped by the test or by serum NSE level stratification of the patients on admission (the accurateχ2valueswere4.063and4.685respectively,P=0.044and0.030respectively).Conclusion Early high-level serum NSE and hyperbilirubinemia can be used as the indexes of early identification of poor prognosis in patients with large-artery atherosclerotic stroke.

Objective To determine the biomechanical parameters of left ventricular by using velocity vector imaging (VVI),and to indirectly assess the coronary artery stenosis with VVI in the patients with coronary artery disease (CAD).Methods 52 patients who had one coronary artery lesions at least diagnosed by coronary angiography (CAG)were divided into coronary artery mild stenosis group and severe stenosis group;2 1 patients in mild stenosis group had one coronary stenosis <75%;31 patients in severe stenosis group had one coronary artery stenosis ≥75% at least.At the same time,20 cases of normal people without coronary artery stenosis showed by CAG were selected as normal control group. VVI was used to detect the left ventricular wall segments of the overall longitudinal strain (GLS ), the overall circumferential strain (GCS ) and the overall radial strain (GRS ). Results The absolute values of GLS,GRS,GCS of the patients in mild and severe coronary artery stenosis groups were significantly decreased than those in normal control group(P<0.05),and the strain parameters in severe stenosis group were decreased more significantly, there were significant differences compared mild stenosis group (P<0.05 ). The distribution of the segments with decreased longitudinal strain matched the LV myocardial segment with the coronary stenosis rate ≥ 75%,and GLS had the most sensitivity.The GLS in normal control group,mild stenosis group and severe stenosis group were negatively correlated to left ventricular ejection fraction (LVEF)(r=-0.58,P<0.05;r=-0.51,P<0.05;r=-0.43,P<0.05).GLS-16.14 % was used to assess the severe coronary artery stenosis with requiring the implementation of PTCA treatment as the diagnostic cut-off point with sensitivity 96.8%, specificity of 70%, the highest Yuedden index 0.668. Conclusion The decreasing of left ventricular strain could be detected by VVI, which suggests that severe coronary artery stenosis exists in coronary artery;the distribution of the segments with significantly decreased strains can be used to assess the coronary lesions and stenosis degrees.