Since the laparoscopic thyroidectomy carried out in China for ten years,this technique has become more and more mature,indications gradually broadened,and playing a vital role in the field of thyroid surgery.This article will explain this technique in the aspects of approaches,the establishment and maintenance of the surgical space,indications,antiindications and complications.

Colorectal cancer is currently the world's fourth incidence of malignant tumors,the early clinical manifestations are not obvious,so the early diagnosis is difficult to find,most of them are in progress.Treatment of advanced stage with chemotherapy,interventional therapy,radiotherapy and other methods,in which chemotherapy in the killing of tumor cells at the same time,the normal cells of the body also has a killing effect.In recent years,all kinds of new nano targeting delivery system has been developed,which can be targeted to the tumor tissue,so it is more and more important in the treatment of intestinal tumor,especially with metastasis.The author has made an overview of the types of nano drug carrier materials,the research status and its application in the research of colorectal cancer.

As one of the most major disease,malignant tumor is harmful to human health.Althought it' s exact pathogenesis is still not clear,it is certainly that the formation of cancer is typical of containing many factors and having gone through many steps.Resulting from the abnormal activation of a series of proto-oncogene as well as the inactivation caused by many anti-oncogene mutation,some signal pathways work abnormally.In recent years,the study of Hedgehog ( Hh),as the signal pathway,shows that Hh encodes a series of secreted signaling protein,having an important effect on the differentiation and proliferation of cells in the process of embryogenesis.The occurrence of abnormal activation of Hh signaling pathway plays a significant role in the process of tumorigenesis.Signal paths of Hh signaling protein include as much as following at least:patched(Ptch),smoothened (Smo),fused (Fu),suppressor of fused (SuFu),costaⅠ-2 (Cos)-2 and cubitus interruptus (Ci) and so on.In this paper,the function of Hh genetic family and the mechanism of its relation to many kinds of human cancers will be givien a brief overview.

There is a long history of Toad venom in the treatment of cancer in China.Bufalin,extracted from Toad venom,is one of the biologically active compounds of anticancer.We elaborate the molecular mechanism of bufalin on anticancer activity from several aspects such as inducing cell apoptosis and differentiation,inhibitting cell proliferation and angiogenesis,enhancing the sensitivity of chemotherapeutics,which can provide the basis for in-depth study of Toad venom and its development and clinical medication.

Extensive researches suggest that the metastasis of colorectal cancer involves multiple factors and genes.Recurrence and metastasis after surgery are the important reasons for poor prognosis of thesc patients with colorectal cancer.Tumorigenesis is a dynamic process.The levels of tumor markers are changed in different stages.It has not yet been found any kind of tumor markers specific for a certain type of colorectal cancer.The sensitivity and specificity of diagnoising colorectal cancer by detecting an individual tumor marker are not ideal.The better combination of tumor markers has its advantages,can improve the early diagnostic rate.Combining detection of tumor markers will improve the diagnostic yield.

Colorectal cancer is a common malignancy in China.The incidence of it showed an increasing trend with the economic development,living standards improvement and lifestyle changes.The traditional treatment methods include surgery,radiotherapy and chemotherapy.In recent years,hyperthermia has become a method for treating tumor.Hyperthermia kills tumor cells by thermal effect and no-thermal effect.Not only does it have a direct therapeutic effect on tumor cells,hyperthermia also has some synergy combined with radiotherapy and chemotherapy.Hyperthermia combined with conventional therapy can improve the local control rate and extend survival for patients.In this paper,the efficacy of hyperthermia has been reviewed,combined with a variety of treatment methods for colorectal cancer in China.

It is to difficult to diagnose and treat hepatobiliary surgical diseases since its diverse clinical manifestations,which increases the difficulty of clinical internship.Taking clinical cases as teaching material,case-based learning was combined with teaching theme and was conducted by means of discussion and question and answer between teachers and students.Students can know about concepts or theories related to teaching theme.Case-based learning in internship can consolidate basic knowledge of hepatobiliary surgery,cultivate clinical scientific thinking and is helpful in analyzing and resolving problems of hepatobiliary surgical diseases.

Objective To investigate the effects of sorafenib combined with dendritic cells and cytokine induced killer (DC-CIK) cells on the growth,invasion and metastasis of hepatocellular carcinoma.Methods CIK cells and dendritic cells from healthy adults were cultured in vitro.Mice models with H22 hepatic cancer were established,and randomly divided into the normal saline group,sorafenib group,DC-CIK group and the sorafenib + DC-CIK group according to the random number table.There were 40 rats in each group.All the mice received intragastric gavage with sorafenib of 100 μg/g once a day.DC-CIK cells were intraperitoneally injected into the mice every 3 days with 1 × 107 cells each time.Twenty mice bearing tumors in each group were sacrificed after treatment for 3 weeks,and the peripheral venous blood and hepatic tumor tissues were harvested.The levels of alphafetoprotein (AFP) were detected by ELISA,and the necrotic degree of tumor tissues was evaluated by hematoxylin and eosin staining.The protein expressions of Ki-67 and CD34 in the tumor tissues were determined by immunohistochemical method.The survival time of the other 20 mice bearing the tumor in each group were detected.All data were analyzed using the analysis of variance or LSD test.Results CIK cells and dendritic cells were successfully cultured.The levels of AFP in the peripheral venous blood of the normal saline group,sorafenib group,DC-CIK group and sorafenib + DC-CIK group were (0.675 ± 0.177) rg/L,(0.379 ± 0.052) ng/L,(0.415 ± 0.028) ng/L,(0.288 ± 0.012) ng/L,with significant difference between the 4 groups (F =0.415,P ＜ 0.05).The numbers of intrahepatic and peritoneal metastasis of the normal saline group,sorafenib group,DC-CIK group and sorafenib + DC-CIK group were 21.2 ± 1.3 and 29.7 ± 7.6,16.4 ± 1.6 and 17.4 ± 1.8,20.2 ± 1.7 and 26.4 ± 1.7,15.2 ± 1.3 and 15.2 ± 1.3,with significant difference between the 4 groups (F =2.137,3.271,P ＜0.05).The tumor inhibition rate of the normal saline group,sorafenib group,DC-CIK group and sorafenib + DC-CIK group were 0,21％ ± 3％,9％ ± 3％ and 24％ ± 5％,with significant difference between the 4 groups (F =3.715,P ＜0.05).The survival time of mice in the normal saline group,sorafenib group,DC-CIK group and sorafenib ± DC-CIK group were (18.2 ± 2.5) days,(21.6 ± 2.1) days,(24.3 ± 2.8) days and (25.4 ± 1.4) days,with significant difference between the 4 groups (F =6.247,P ＜ 0.05).Conclusions Sorafenib combined with immunotherapy can significantly increase the therapeutic effects of molecular targeted drug on hepatocellular carcinoma.

Background and purpose:Suppression of apoptotic signaling pathways is an important factor in tumor cell resistance. Research on cell apoptosis will open up a new way of reversing drug resistance and tumor treatment. This study examined the effects of a novel naphthalimide derivative 8c on multidrug resistant colon cancer HCT116/L-OHP cells and explored the molecular mechanisms underlying the apoptosis induction. Methods: The anti-proliferative effects of 8c were detected by CCK-8 assays and the effects on apoptosis induction were examined by lfow cytometry. The mRNA expression levels of p53, Bax and Bcl-2 were measured by real-time PCR;The protein expressions of p-p53, Bax, Bcl-2 and Cyt-c were detected by Western blot. Results:8c (IC50=8.16 μmol/L) seemed to be more potent than amonaifde (IC50=28.37 μmol/L) against HCT116/L-OHP cells. 8c induced apoptosis on HCT116/L-OHP cell lines through intrinsic or mitochondria dependent pathway. The protein expression of phosphorylation of p53 at Ser-15 was increased, but the mRNA level of p53 did not increase in HCT116/L-OHP cells. Bax protein and mRNA levels were signiifcantly increased, and Bcl-2 protein and mRNA levels were decreased, suggesting an increase of Bax/Bcl-2 ratios. Meanwhile, 8c induced a substantial release of cytochrome c from the mitochondria into the cytosol in HCT116/L-OHP cells. Conclusion: 8c induced cell death signal by inducing the activation p53 phosphorylation which subsequently activated related protein expressions of apoptotic pathway, which may be an important mechanism of 8c on inhibiting proliferation of HCT116/L-OHP resistant cells. All the results suggested that 8c was a potent compound to be developed as an anti-tumor and anti-resistance agent for clinic application in the future.

Objective To study the effect of brucine on the growth of a hepatocellular carcinoma cell line in vitro. Methods Brucine was added into a liver cancer cell line of SMMC-7721 in vitro, at drug concentration of brucine from 2. 5 μg/ml to 400 μg/ml. The inhibition rate of cell growth was measured by MTT technique after the cells were cultured for 72 hours. The protein and mRNA expression of PCNA,cyclin D1 and FAS were respectively assayed with Western blotting and fluorescent quantitation RT-PCR techniques at 24, 48, 72 h. Results The inhibition rate of liver cancer cell was near 100% when the brucine concentration was at 320 μg/ml. The protein and mRNA expression of FAS were of no significant difference at 24 h vs 48 h ( seperately F = 2. 547,1. 582, all P ＞ 0. 05 ), and significant difference existed at 24 h vs 72 h( seperately F = 1. 036, 1. 137, all P ＜ 0. 05 ). The protein and mRNA expression of PCNA,Cyclin D1 were of no significant difference between various time period( seperately PCNA F = 3.612,2. 174,3.029;Cyclin D1 F=2.361,2.915,1.976,all P＞0.05). Conclusions Brucine inhibits the growth of liver cancer cells, by inducing increased apoptosis of the cells probably through FAS overexpression.