Liver metastasis is one of the main causes of treatment failure in colorectal cancer, and the key to improve the efficacy of treatment is to adopt precision therapy. Oligometastatic classification clearly defines the treatment methods and goals for distinguish-ing liver metastases, as well as promotes nonsurgical methods for local treatments. In addition to RAS oncogene, other biomarkers with prognostic and therapeutic predictive values urgently need to be identified. Precision therapy encompasses the entire course of optimal treatment in colorectal liver metastases (CRLM) including the following:optimization of therapy sequence for initial resectable liver metastases, treatment predictive value of KRAS oncogene for liver resection, selection of sensitive subgroups for conversion ther-apy, application of the optimal follow-up strategy, and formulation of individual comprehensive treatment regimens. This review focus-es on the recent progress of precision treatment for CRLM.

Objective To review the outcome of coronary artery bypass graft (CABG) using left internal thoracic artery grafts in the patients aged over 70 years old.Methods Two hundred and eighty-eight patients aged over 70 years old from January 2009 to January 2014 who underwent CABG were selected.All of the patients were divided into two groups on base of the graft:control group:only saphenous vein graft was used in 138 cases; observation group:the left internal thoracic artery to the left anterior descending artery was used in 150 cases,which also included total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 7 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.9％ (4/138) in control group and 2.0％ (3/150) in observation group,and there was no significance (P ＞ 0.05).The volume of blood drainage was larger in observation group [(796.2 ± 382.4) ml] than that in control group [(512.8 ± 387.5) ml],and there was significant difference (P ＜ 0.05).At the same time,there was no significant difference in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of intraaortic balloon counterpulsation between two groups (P ＞ 0.05).Conclusion It does not increase the mortality and incidence of serious complications using the left internal thoracic artery to the left anterior descending artery in the patients aged over 70 years old during CABG.

Objective To investigate the predictive value of epicardial adipose tissue(EAT) thickness for the recurrence of atrial fibrillation (RAF) after concomitant valve replacement and bipolar radiofrequency ablation.Methods From January 2012 to May 2014,156 patients with permanent atrial fibrillation and organic valvular diseases underwent concomitant valve replacement and successful bipolar radiofrequency ablation in the First People's Hospital of Shangqiu.After 1 year of follow-up,the recurrence of AF was analyzed and the correlation factors were analyzed statistically.Results All patients completed a regular follow-up.During a 12-month follow-up period,RAF was observed in 39 patients (25.0％).Echocardiography-derived regional EAT thickness was significantly greater in RAF patients than that in non-RAF patients((6.9±0.6) mm vs.(5.5±0.7) mm,t=4.649,P＜0.05).The EAT thickness strongly correlated with patients age,body mass index,Ratio of left atrial diameter,mitral diastolic blood flow velocity and early diastolic velocity of mitral annulus,low density lipoprotein-cholesterol and thyroglobulin (r =0.62,0.57,0.68,0.59,0.73,0.76;P ＜ 0.05).Cox multivariable analysis showed that,duration of AF history (95％CI:1.01-1.15,P =0.040),left atrial diameter (95％CI:1.07-1.24,P =0.021) and EAT thickness (95％CI:1.05-1.79,P =0.009) were independent predictors of RAF.Conclusion Echocardiography-derived regional EAT thickness combined with left atrial diameter may serve as effective parameters in identifying patients at the highest risk for RAF.

Objective To investigate the effect of curcumin on chronic pancreatitis in rat.Methods Eighteen one-month old male SD rats were randomly divided into control group,ANP group and curcumin group with 6 rats in each group.After fed by 25％ alcohol for twelve weeks,the rats in ANP group were intraperitoneally injected with lipopolysaccharides ( LPS,2 mg/kg body weight) once a week for 4 weeks.The rats in curcumin group were fed with curcumin when they were intraperitoneally injected with lipopolysaccharides.Seventeen weeks later,the rats were sacrificed.Serum glucose was measured,pancreatic morphology was routinely examined,collagen deposition was determined by Masson stain,and the amylase and lipase in pancreatic tissue were evaluated,TGF-β1 mRNA was determined by using RT-PCR.Results The pathological score of control group,ANP group and curcumin group was 1.17 ±0.41,7.33 ±2.58 and 3.50 ± 1.05,and the score in curcumin group was lower than that of ANP group (P ＜ 0.01 ),but which was higher than that in control group (P ＜ 0.05 ).There was no difference in the serum glucose among the groups.The levels of amylase and lipase in pancreatic tissue were (7348 ± 102 ),( 14135 ± 1272) U/g,which were significantly higher than those in ANP group[( 5428 ± 547 ) and (9123 ± 1250 ) U/g,P ＜ 0.05].The expressions of TGF β1 mRNA in control group,ANP group and curcumin group were 0.618 ± 0.019,0.818 ±0.012,0.745 ±0.088,and the values in ANP group were significantly higher than those in control group and curcumin group (P ＜ 0.01 ).Conclusions On the basis of long term ethanol intake,repeatedly intraperitoneal injection of LPS can induce chronic pancreatitis,and curcumin has anti-fibrosis effect possibly by its inhibitory effect on the expression of TGF-β1.

AIM: To investigate the differentiation of human mesenchymal stem cells (MSCs) into neuron-like cells induced by the supernatant of rat C6 glloma cells. METHODS: The heparin anticoagulant human bone marrow sampling was performed and human MSCs were separated flom human bone marrow using Percoll gradient method, followed by trypsinization and passage culture. When the MSCs at 4-6 passages reached a confluence of 90%, they were inoculated into a 24-well culture plate at a density of 2×103 per well. Cells were then divided into induction group and control group. In the induction group, C6 glioma cells were induced by the complete culture medium supplemented with 50% C6 glloma ceils supernatant (L-DMEM containing 0.1 fetal bovine serum), and half of the culture medium as replenished every 2 days. In the control group, cells were cultured in the complete culture medium. Both groups were treated 3 days and the expression of neuron-specific marker was monitored with S-P immunocytochemical stain. RESULTS: After an induction period of 24 hours, the differentiated MSCs showed typical neuron-like appearance, while the controlled cells exhibited no obvious alters. After 3 days of the induction, the neuron specific enola,se-positive rate of the cells in the induction was significantly higher than that in the control group (P < 0.01). The neurofilament protein-positive rate of cells in the induction group was (44.2±2.4)%, and the control group cells did not express neurofilament protein. Typical glial astrocyte marker glial fibrillary acidic protein was negatively expressed in both groups. CONCLUSION: Differentiation of MSCs into neuron-like cells can be induced by the supematant of rat C6 glioma cells in vitro.

Objective To study the clinical effect of triethanolamine cream in treatment of traumatic wounds and its effect on level of interleukin-2 (IL-2), interleukin-8 (IL-8) and tumor necrosis factor-α(TNF-α).Methods 88 patients with traumatic wounds were selected in our hospital from February 2015 to January 2016, those patients were divided into observation group and control group according to coin method.The control group was treated with alginate dressing, observation group were given triethanolamine cream for treatment.The levels of IL-2, IL-8, TNF-αand visual analogue scale(VAS) between the two groups were compared.The clinical curative effect of the two groups was evaluated.Results After treatment, the total effective rate of the observation group(90.91%) was significantly higher than the control group (68.18%).There were no significant differences in VAS scores between the two groups before treatment, 5, 10,20 days after treatment, the VAS scores of the two groups were significantly lower than before treatment (P<0.05), at 5,10,20 days after treatment, the VAS scores in the observation group were significantly lower than the control group (P<0.05).The level of IL-2 in the observation group were significantly higher than the control group, the levels of IL-8,TNF-αwere significantly lower than the control group (P<0.05).Conclusion Triethanolamine cream can increase the level of IL-2 and decrease the levels of IL-8 and TNF-αin patients with traumatic wounds, it can relieve the pain of patients and has good clinical curative effect.

Objective To evaluate if mucinous subtype has a relevant impact on disease-free survival (DFS) of patients with rectal carcinoma.Methods The clinicopathological data of patients with rectal adenocarcinomas (ring cell carcinoma were excluded)undergoing radical surgery at Beijing Cancer Hospital from Jan 2010 to Jan 2012 were retrospectively studied,survival analysis was done to detect potential prognostic predictors.Results 353 patients with stage Ⅰ-Ⅲ rectal cancer were included in this study,of whom 28 (7.9％) had mucinous histology.The 3-year DFS for patients with a mucinous adenocarcinoma was 50.0％ and 83.4％ for patients with nonmucinous adenocarcinoma (P ＜ 0.001).Mucinous adenocarcinoma was associated with advanced pathologic T (T3/4,100％ vs 52.3％,P ＜0.001) and N stage (N1/2,64.3％ vs.32.6％,P =0.001).More patients were diagnosed under 40 years in mucinous adenocarcinoma group (21.4％ vs.5.5％,P =0.005).Conclusions Patients with mucinous adenocarcinoma more often present at a younger age,mucinous adenocarcinomas are associated with more advanced tumor stages,and should be regarded as a dismal prognostic factor for the survival of patients with rectal cancer.

Objective: To evaluate the effects of PD145065(non-selective endothelin(ET)receptor antagonist)on injured spinal cord and explore mechanisms of how ET plays a role in secondary injury following spinal cord injury(SCI).Methods:Spinal cord of rat was traumatized by compression(50g,1min).PD145065 or vehicle was administered intrathecally 10 minutes before SCI.Alterations of spinal cord blood flow(SCBF),molondialdehyde(MDA),the total content of intracellular calcium(［Ca2+］i),Evans blue(EB),and water in spinal cord were inspected.Results:SCBF of injured area decreased obviously 5 minutes after SCI.SCBF was 75.23±9.21% of baseline 5 minutes after SCI,57.06±7.35% 2 hours.SCBF of adjacent area decreased lower.SCBF was 79.82±7.98% of baseline 30 minutes after SCI.SCBF of injured and adjacent areas did not recover 4 hours after SCI.The contents of MDA,［Ca2+］i,EB and water in traumatized spinal cord were significantly more than that of sham(P＜0.05)。PD145065 ameliorated SCBF of injured area obviously and abolished the decrease of SCBF of adjacent area.The contents of MDA,［Ca2+］i,EB and water in spinal cord of PD145065 treated group were significantly less than that of saline treated group(P＜0.05).Conclusion:PD145065 has protective effects on traumatized spinal cord in early phase.ET and its receptors may play a role in secondary injury following SCI by multiple pathways.ETA/ETB receptor antagonist may be useful in treatment of clinical SCI.

Objective To investigate the role of Chinese traditional medicine-Tianlongchuankeling in modulation of the transdifferentiation of sub-epithelial fibroblasts into myofibroblasts induced by rhTGF-?1,and the involved mechanism of the signal transduction.Methods Human primary bronchial sub-epithelial fibroblasts(HPBFs)were incubated with either Tianlongchuankeling or its main components of Qingtiankui,Danfuzi and Faxia respectively before being treated with rhTGF-?1(10 ?g/L)for different time.Total protein of cells were collected at different timelapse(10min,30min respectively).Phosphorylated MAPKs for p38,ERK1/2,phosphorylated smad2 and the expression of ?-SMA were detected by using Western blotting.Total RNA was extracted at 20 h and 72 h and subjected to RT-PCR for evaluation of the expression of ?-SMA gene.Results The induction of ?-SMA in HPBFs by TGF-?1 was down-regulated significantly in the cells treated with Tianlongchuankeling or Danfuzi.The phosphorylation of ERK1/2 under TGF-?1 stimulation was inhibited significantly in Tianlongchuankeling and Danfuzi group.No difference of the level in phosphorylation of p-38 and smad2 was found among groups.Conclusion Tianlongchuankeling has the capability to suppress the induction of ?-SMA by TGF-?1 through down-regulation of the phosphorylation of ERK1/2,thereby preventing the transdifferentiation of sub-epithelial fibroblasts into myofibroblasts,which may be responsible for the treatment of airway hyperresponsiveness in asthma.Danfuzi,one of main components of Tianlongchuankeling,may make a major contribution to this process.

Objective To study the distribution pattern of rare earth elements (REEs) in hair of young children. Methods REEs level and distribution pattern in hair of young children aged 0～30 months in RE ore area were studied. All the lanthanide elements were determined with inductively coupled plasma mass spectrometer (ICP_MS) in 20 hair samples of young children aged 0_3yrs, 10 samples from RE ore area and 10 samples as controls from Xunwu county, Jiangxi, China. Results 15 kinds of REEs in each sample were all detected. There were significant differences between higher children's hair REEs levels of RE ore area and those lower levels of control site (P