Primary liver cancer ( PLC) , the most com-mon malignant carcinoma in the world , greatly impairs the hu-man health .Various treatments for PLC have been practiced but the therapeutic effects are still unsatisfied .Nowadays, interven-tional therapy , chemotherapy , radiotherapy , molecular targeted therapy and radiofrequency ablation are playing a key role in hepatocellular carcinoma treatment .In near future , more ad-vancements on comprehensive therapy for PLC are being expec-ted.This review aimed to describe the recent scenario and cur-rent advancement on non-surgical treatment for hepatocellular carcinoma .

Objective To investigate the effect of STAT3 knockdown on the sensitivity of breast cancer cells with drug-resistant to adriamycin (MCF-7/ADR). Methods Levels of STAT3 and p-STAT3 in MCF-7/ADR and MCF-7 cells were detected by Western Blot. The MCF-7/ADR cells were infected with lentivirus expressing STAT3-shRNA and the negative control vectors in the STAT3-RNAi group and NC group, respectively, wihle the cells in the blank group received no treatment. The transfection efficiency was observed with fluorescence microscope, the mRNA level of STAT3, protein levels of STAT3 and p-STAT3 were detected by qRT-PCR and Western Blot, respectively. MCF-7/ADR cells were treated with different concentrations of adriamycin for 48 hours, cell proliferation was detected by MTT assay and cell apoptosis was detected by flow cytometry. Results Levels of STAT3 and p-STAT3 in MCF-7/ADR cells were significantly higher than those in the MCF-7 cells (P < 0.05). The levels of STAT3 mRNA, STAT3 and p-STAT3 in the STAT3-RNAi group were significantly lower than those in the Con group and the NC group (P<0.05, respectively). The Adriamycin IC50 in the Con group, NC group and STAT3-RNAi group was (56.1 ± 3.00)ug/mL,(54.9 ± 11.9)ug/mL and (7.6 ± 0.2)ug/mL, respectively. The flow cytometry results showed that the cell apoptosis in the Con group, the NC group and the STAT3-RNAi group was (10.5+0.7)%, (11.7+0.7)%and (34+3.1)%, respectively. Conclusion LV-shRNA-STAT3 can significantly inhibit STAT3 expression and enhance the sensitivity of breast cancer cells to adriamycin, and the underlying mechanism may be related to cell apoptosis.

Background and purpose:In preparation for using this tracer in humans, this study estimated thedosimetry of18F-FES with the method established by MIRD based on whole-body PET imaging of mice.Methods:Three female mice receivedⅣ tail injections of18F-FES and were scanned for 160 min in an Inveon dedicated PET/CT scanner. This study selected some important organs (brain, lung, liver, heart wall, small intestine, large intestine, kidney and urinary bladder), computed their residence times. Then, the residence times in mice organs were converted to human values using scale factors based on differences between organ and body weights. OLINDA/EXM 1.1 software was used to compute the absorbed human doses in multiple organs for both adult female and adult male body phantoms. Results:The highest absorbed doses in gallbladder wall, urinary bladder wall, small intestine, upper large intestine and liver are 0.072 5, 0.044 5, 0.043 0, 0.031 5 and 0.028 2 mGy/MBq, respectively. The organs which have the lowest ab-sorbed doses were brain (0.005 2 mGy/MBq), followed by skin (0.001 1 mGy/MBq), breast (0.001 1 mGy/MBq), heart wall (0.001 2 mGy/MBq) and thyroid (0.001 2 mGy/MBq). The mean absorbed doses for the other major organs ranged from 0.009 5 to 0.023 5 mGy/MBq. The total mean effective dose is 0.019 0 mSv/MBq and the mean effective doses equivalent is 0.025 0 mGy/MBq. A 370-MBq injection of18F-FES leads to an estimated effective dose of 7.03 mSv for the female. There was no statistical difference in the doses results obtained from direct measurement of18F-FES ab-sorption in normal people between previous publications by others and our work.Conclusion:The whole-body mouse imaging can be used as a preclinical tool for initial estimation of the absorbed doses of18F-FES in humans. Furthermore, the potential radiation risk associated with18F-FES imaging is well within the accepted limits.

Objective To evaluate the clinical outcomes of sacral decompression and lumbopelvic fixation for neurologically impaired patients with sacral fracture-dislocation.Methods From January 2009 to December 2013,32 patients with sacral fracture and spino-pelvic dissociation of Roy-Camille types Ⅱand Ⅲ were treated at our department.They were 21 men and 11 women,with a mean age of 34.3 years.According to Roy-Camille classification,9 patients belonged to type Ⅱand 23 to type Ⅲ;25 patients had S1 fracture-dislocation and 7 S2 fracture-dislocation.After their overall conditions were stabilized,all were treated with open reduction,sacral decompression and lumbopelvic fixation.Pre-and post-operative neurological functions were recorded by Gibbons criteria.We analyzed the correlations between the neurological recovery and (i) the extent of cauda equina deficit and (ii) the continuity of sacral roots,as well as the correlations between the functional recovery of the bladder and bowels and the above two.The reduction and fusion status were evaluated by the Mears and Velyvis radiological criteria;clinical effectiveness was evaluated by Majeed scoring system.Intra-and post-operative complications were all recorded.Results The mean follow-up time for this series was 35 months (from 25 to 47 months).The average Gibbons score improved from 4.0 to 2.7 at the follow-ups.The patients with mild cauda equina deficit or with continuity of sacral roots achieved significantly better neurological recovery than those with severe cauda equina deficit or with discontinuity of sacral roots (P ＜ 0.001).However,the functional recovery of the bladder or bowels was not significantly correlated with the extent of cauda equina deficit or with the continuity of sacral roots.Anatomical reduction was achieved in 26 patients,satisfactory reduction in 5 and unsatisfactory reduction in one,yielding a satisfaction rate of 96.9％.Bony fusion was obtained in 29 patients at 3 months,but not until at 9 months in 2 patients,and still not at 9 months in one who showed no symptoms.The Majeed scoring showed 22 excellent,6 good and 4 moderate cases,giving an excellent to good rate of 87.5％.Two patients developed deep wound infection,3 complained of the pain related to hardware prominence,and one had unilateral rod breakage.Conclusions In treatment of sacral fracture with spino-pelvic dissociation,sacral decompression and lumbopelvic fixation can lead to effective neurological recovery,restoration of lumboscacral stability and alignment,early ambulation and prevention of deformity.Complete neurological recovery is more likely in patients with incomplete cauda equina deficit or with continuity of all sacral roots.

Objective To investigate the correlation factors for surgical outcome of sacral decompression and lumbopelvic fixation in H-shaped sacral fracture and the methods to prevent and treat the complications.Methods From January 2008 to January 2016,45 patients with H-shaped sacral fracture treated by sacral decompression and lumbopelvic fixation were respectively analyzed,including 29 men and 16 women,mean age 41.2 (range,24-53 years),mean follow-up time 52.6 months (range,16-93 months).The surgical outcome was evaluated by pelvic outcome score,and correlation factors were analyzed.We analyzed whether each factor was in correlation with pelvic outcome score.Then we integrated the statistically significant indicators into Logistic regression equation to determine the related factors.Postoperative complications were all recorded.Results The average operation time was 161.2 min (range,100-220 min),average blood loss was 491.6 ml (range,370-1 000 ml),injury-surgery interval was 7.2 d (range,1-23 d).In terms of pelvic outcome score,31 (68.9％) patients had satisfactory result and 14 (31.3％) patients had unsatisfactory result.Univariate x2 analysis suggested that cauda equina injury,Roy-Camille classification,L5S1 facet injury,fracture line,kyphotic angle,injury-surgery interval,decompression approach and inserting sacral screws were correlated with pelvic outcome score,but gender,age,injury mechanism and L5 pedicle fracture had no relation with pelvic outcome score.The multivariate Logistic regression analysis showed that cauda equina injury,Roy-Camille classification,fracture line,kyphotic angle,injury-surgery interval,decompression approach and inserting sacral screws were closely related to pelvic outcome score,but L5S1 facet injury was excluded.2 patients required early surgical procedures with proper antibiotics for deep wound infection;3 patients complained pain related to hardware prominence and the pain subsided after removal of implants;1 patient got unilateral rod breakage at 3-6 months and achieved bony fusion after nine months of observation.Conclusion Sacral decompression and lumbopelvic fixation is effective in neurological recovery and early ambulation in treating H-shaped sacral fracture.Better surgical outcome is related to timely surgery,preoperative or intraoperative bone traction,sacral screws insertion,incomplete cauda equina injury,Roy-Camille type Ⅱ,fracture line penetrating S2 and kyphotic angle less than 40°.

Objective:To investigate the effects and the possible mechanisms of Neiguan(PC6)and Gongsun(SP4)on the hypothalamic-pituitary-adrenal(HPA)axis in rats with functional dyspepsia(FD),thus to provide a theoretical basis for the clinical application of the Eight Confluent Points.Methods:Forty specific-pathogen-free Sprague-Dawley rats were divided into a blank group,a model group,an electroacupuncture(EA)group,and a Western medicine group by the random number table method,with 10 rats in each group.Rats in the blank group did not receive modeling or intervention.Rats in the other three groups were subjected to the FD with mood disorder model using the compound etiology modeling method.After the successful modeling,rats in the model group did not receive any interventions,rats in the Western medicine group received deanxit and mosaprid intervention,and those in the EA group received EA intervention on the ipsilateral Neiguan(PC6)and Gongsun(SP4)for 21 d.The sugar-water consumption rate was measured before the experiment and before and after interventions to assess the emotional status.The gastric emptying rate was measured after interventions to assess the gastrointestinal dynamics.The expression levels of hypothalamic corticotropin-releasing hormone(CRH),pituitary adrenocorticotropic hormone(ACTH),and adrenal corticosterone(CORT)were measured by enzyme-linked immunosorbent assay.Results:Compared with the blank group,the sugar-water consumption rate and the gastric emptying rate were decreased(P<0.01),and the hypothalamic CRH,pituitary ACTH,and adrenal CORT expression levels were increased(P<0.01)in the model group.Compared with the model group,the sugar-water consumption rate and the gastric emptying rate were significantly increased(P<0.01),while the expression levels of hypothalamic CRH,pituitary ACTH,and adrenal CORT were significantly decreased(P<0.01)in the EA group and the Western medicine group.The differences between the EA group and the Western medicine group were not statistically significant(P>0.05).Conclusion:The Eight Confluent Points Neiguan(PC6)and Gongsun(SP4)can improve the mood and gastrointestinal dynamics in FD rats,which may be achieved by down-regulating the hypothalamic CRH,pituitary ACTH,and adrenal CORT,as well as by correcting the HPA axis hyperfunction.

Objective To compare the efficacy of pedicle screw with vertebroplasty ( PSV) or intermediate screw ( PSIS ) for osteoporotic thoracolumbar compression fractures. Methods A retrospective case control study was conducted to analyze the clinical data of 141 patients with osteoporotic thoracolumbar vertebral compression fractures admitted to Honghui Hospital, College of Medicine, Xi'an Jiaotong University from January 1, 2012 to December 31, 2015. There were 59 males and 82 females,aged 60-75 years, with an average age of 65. 4 years. All the fractures had bone mineral density (BMD) T value < -2. 5 SD, kyphosis angle > 15 degrees or anterior column compression > 40％. There were 65 patients with thoracic vertebral fractures ( T10-T12 ) and 76 with lumbar vertebral fractures ( L1-L4 ) . Among all patients, 68 received PSV treatment ( PSV group) and 73 received fixed PSIS treatment ( PSIS group). The operation time, intraoperative blood loss, visual analogue scale (VAS), anterior height ratio, central height ratio, and segmental kyphosis angle at 3 days, 3 months, 6 months, 1 year and 2 years after operation were compared between the two groups. The complications were recorded. Results All patients were followed up for 25-31 months, with an average of 27. 9 months. There were no significant differences in operation time and intraoperative blood loss between the two groups (P>0. 05). VAS at each time point of postoperative follow-up was significantly lower than those before operation in both groups (P<0. 05). Except that VAS in PSV group was lower than that in PSIP group 3 months after surgery [(2. 2 ± 0. 8)points vs. (2. 6 ± 0. 6)points] (P<0. 05), there were no significant differences in VAS at other time points between the two groups (P>0. 05). Anterior height ratios of PSV group were higher than those of PSIP group at postoperative 3 months, 6 months, 1 year and 2 years (P<0. 05) [(95. 2 ± 5. 2) vs. (92. 6 ± 7. 1), (93. 8 ± 5. 2) vs. (91. 4 ± 3. 2), (93. 3 ± 4. 9) vs. (91. 2 ± 5. 1), (92. 6 ± 5. 5) vs. (90. 1 ± 4. 7)]. The central height ratios of PSV group were higher than those of PSIP group at postoperative 6 months, 1 year and 2 years [(91. 4 ± 6. 9) vs. (88. 9 ± 7. 2), (90. 8 ± 7. 4) vs. (88.4±5.9),(90.1±7.6)vs. (87.1±7.2)](P<0.05). SegmentalkyphosisangleofPSVgroup was lower than that of PSIP group at postoperative 3 months, 6 months, 1 year and 2 years [(2. 9 ± 0. 4)° vs. (3. 2 ± 0. 9)°, (3. 0 ± 0. 5)° vs. (3. 2 ± 0. 3)°, (3. 1 ± 0. 7)° vs. (3. 4 ± 0. 4)°, (3. 1 ± 0. 4)° vs. (3. 4 ± 0. 7)°] (P <0. 05 or 0. 01). Bone cement leakage from screws occurred in two patients in PSV group and three patients in PSIS group. Cement leakage occurred in the injured vertebra in four patients of PSV group, with no any symptom. In PSIS group, two patients suffered from one side rod breakage at 9 months and 1 year after surgery, respectively. CT showed sound bone healing, without any further management. Conclusion For osteoporotic thoracolumbar compression fractures, PSV can attain similar pain relief compared with PSIS, but the former is more conducive to reducing the loss of anterior and middle column height and correcting kyphosis deformity.

Objective:To investigate the efficacy of the novel bone cement bridging screw system combined with percutaneous vertebroplasty (PVP) in the treatment of symptomatic chronic osteoporotic vertebral fractures (SCOVF) with intravertebral vacuum cleft (IVC).Methods:A retrospective case series study was used to analyze the clinical data of 27 patients with SCOVF admitted to Honghui Hospital affiliated to Xi′an Jiaotong University from August 2016 to August 2018, including 6 males and 21 females; age 69-88 years [(75.2±4.9)years]. All patients were treated by the novel bone cement bridging screw combined with PVP. The operation time, amount of bone cement injected and occurrence of bone cement leakage or displacement were recorded. The vertebral body index (VBI), vertebral body angle (VBA), two-segment Cobb angle (BCA), visual analogue score (VAS) and Oswestry disability index (ODI) were compared preoperatively, at day 1 after operation and at the last follow-up. The results of the MOS 36-item short form health survey (SF-36) and Odom′s criteria were compared preoperatively and at the last follow-up to evaluate pain relief and neurological recovery.Results:All patients were followed up for 36-48 months [(40.2±3.7)months]. The operation time was 37-70 minutes [(49.6±10.8)minutes], with the amount of bone cement injected for 3-6 ml [(34.7±0.9)ml]. Intraoperative bone cement leakage occurred in 4 patients (15%), among which 3 had lateral vertebral leakage and 1 superior intervertebral disc leakage. There was no bone cement displacement during the postoperative period to the last follow-up. The VBI, VBA, BCA, VAS and ODI were (43.1±5.9)%, (21.0±2.6)°, (45.0±6.3)°, 7.6 (7.0, 8.0)points, (79.9±7.6)% preoperatively, were (78.7±2.6)%, (12.7±2.1)°, (26.1±4.7)°, 3.2 (3.0, 4.0)points, (50.0±9.3)% at day 1 after operation, and were (78.0±2.3)%, (13.2±2.4)°, (27.1±4.9)°, 2.0 (2.0, 2.0)points, (22.9±5.1)% at the last follow-up. There were significant differences in above five measures at day 1 after operation and at the final follow-up in comparison with the preoperative values (all P<0.05), and their values measured at day 1 after operation and at the final follow-up were also significantly different (all P<0.05). The SF-36 score in physical function, role physical, body pain, vitality and social function was 45.2 (40.0, 50.0)points, 28.7 (25.0, 50.0)points, 15.9 (10.0, 22.0)points, 48.3 (40.0, 60.0)points, 29.2 (25.0, 37.5)points preoperatively, significantly different from 78.0 (75.0, 85.0)points, 75.0 (75.0, 75.0)points, 68.1 (64.0, 74.0)points, 62.0 (55.0, 70.0)points, 34.7 (25.0, 37.5)points at the last follow-up (all P<0.05). However, there were no significant differences in SF-36 before operation and at the last follow-up in dimensions of general health, emotional function and mental health (all P>0.05). According to Odom′s criteria, 19 patients were graded as excellent, 7 good, 1 fair and 0 poor, with an excellent and good rate of 96%. Conclusion:For SCOVF patients with IVC, the novel bone cement bridging screw system combined with PVP has advantages of no displacement of bone cement, satisfactory fixation, significant pain relief and satisfactory functional recovery.

Objective To investigate outcomes of posterior instrumentation and fusion in treating ankylosing spondylitis (AS) combined with lower cervical fractures.Methods A retrospective case series study was made on 53 AS patients combined with cervical fractures or cervical thoracic fractures treated by posterior instrumentation and fusion from January 2006 to January 2013.There were 51 male and 2 female patients.The mean age of patients was 55 years old (range,34-69 years old).All the patients showed significant kyphosis on the thoracolumbar and cervicothoracic junction.A total of 20 patients had neurological dysfunction at different extents.According to the American spinal injury association (ASIA) classification,neurological status was scored as Grade A in 4 cases,Grade B in 5,Grade C in 4 and Grade D in 7.The operation time,total bleeding and decompression status were recorded during the surgery.Reduction,decompression condition and complications were evaluated.The neurological status and bone fusion were recorded at the follow-up.Results All surgeries were well accomplished.Mean surgical time was 3.7 h (range,2.9-5.3 h).Mean total bleeding was 690 ml (range,470-1 600 ml).Two patients died within 1 year follow-up because of internal diseases (1 case caused by respiratory system disease in 13 months postoperatively and 1 case caused by acute myocardial infarction in 15 months postoperatively).The mean follow-up time of other patients was 25 months (range,18-48 months).The CT scan manifested all patients achieved satisfactory fusion,and the mean time span of the fusion was 3.5 months (range,3-6 months) postoperatively.Among the 20 patients with various levels of neurological deficits before operation,the postoperative ASIA score was Grade A in 4 cases,Grade C in 2,Grade D in 4,and Grade E in 10.No instrumentation failure occurred during follow-up.Conclusion The posterior instrumentation and fusion for treating AS combined with cervical fractures can obtain satisfactory neurological results,spinal stabilization and clinical results,and hence an effective clinical problem-solving algorithm for such kind of patients.

Objective:To investigate the serotype features of group B Streptococcus (GBS) vaginal colonization in late pregnancies and their relationship with early-onset neonatal GBS disease (GBS-EOD). Methods:Thirty-two strains were isolated from neonates delivered by GBS-positive mothers and hospitalized for GBS-EOD in Xiamen Maternal and Child Care Hospital from June 2016 to June 2018. Another 266 strains were isolated from vaginal samples from randomly selected late pregnant women who received antenatal screening and delivered in the same hospital during the same period with an allocation ratio of 12∶1. A total of 298 strains from mothers and 32 strains from neonates were involved. Every isolate was serotyped with latex agglutination assay. GBS infection caused by eleven serotypes and the correlation between GBS serotypes in late pregnant women and neonatal GBS-EOD were analyzed. Qualitative variables were compared using Chi-square or Fisher's exact test. A correlation analysis was presented by the column contact number C. Multiple analysis of multiple sample rates was performed with Post hoc testing. Differences between groups were analyzed according to the adjusted standardized residual. Results:A total of nine serotypes were identified among the 298 strains isolated from the mothers. The most prevalent serotype wasⅢ [55.0% (164/298)], followed byⅠb [16.4% (49/298)], Ⅰa [11.1% (33/298)], Ⅴ [9.4% (28/298)], Ⅱ [5.0% (15/298)], non-typable [NT, 1.0% (3/298)], and Ⅵ, Ⅷ and Ⅸ [0.7% (2/298) in each]. Neither Ⅳ nor Ⅶ serotype was identified. The 32 strains isolated from neonates with GBS-EOD belonged to five serotypes, which were Ⅲ [18/32 (56.3%)], Ⅰa [8/32 (25.0%)], Ⅰb [3/32 (9.4%)], Ⅱ [2/32 (6.2%)] and Ⅴ [1/32 (3.1%)]. The positive rates of GBS Ⅲ serotype in neonates with pneumonia, sepsis, and meningitis were 6/13, 7/14, and 5/5. However, no statistically significant difference was observed in the distribution of the five serotypes in GBS-EOD neonates ( P=0.654). Thirty neonates (93.7%) were cured, while two (6.3%) died. There were statistically significant differences among neonatal GBS-EOD caused by vertical transmission with Ⅰa, Ⅰb, Ⅱ, Ⅲ and Ⅴ, Ⅵ, Ⅷ, Ⅸ and NT serotypes ( P=0.046, contingency coefficient: 0.183). Further analysis showed that the adjusted absolute value of the standardized residual of serotype Ⅰa was 2.7 (>2), and the difference was statistically significant. However, the adjusted absolute value of the standardized residual of serotype Ⅲ was only 0.1, which was not statistically significant. Conclusions:Serotype Ⅲ is the most prevalent GBS serotype in late pregnant women and GBS-EOD neonates, and also the predominant serotype in infants with early-onset meningitis. Serotype Ⅰa could be highly vertically transmitted, while the virulence of serotypes Ⅲ and Ⅰa strains of GBS are the strongest.