The protein,the fats,the carbohydrate and the nucleic acid are the main constituent material of normal cell and organizations. In the early process of becoming malignant,these chemical substance's structure,the conformation and quantity has had the obvious change,but this time clinical symptoms and medicine phantom study still has not obvious change.But the Raman spectrum can actually reflect these changes.Therefore the Raman spectrum technology becomes important means of the malignant tumor early diagnosis and the cancer mechanism research hopefully.This article makes a summary on the present as well as the progress reviewed of Raman spectrum technology in the tumor research application.

The treatment principle for primary liver cancer referring as hepatocellular carcinoma (HCC) in this article is comprehensive treatment based on radical hepatectomy. Focusing on improving the resection rate and reducing the recurrence rate after operation, the conversion therapy, preoperative neoadjuvant therapy and postoperative adjuvant therapy have emerged to become potentially curative strategies and research hotspots. HCC is highly invasive and often complicated with cirrhosis, so comprehensive treatment is essential for better prognosis. However, due to the controversy of surgical indications and heterogeneity among individuals, the concepts and treatment methods of above three therapies, especially between the conversion therapy and the preoperative neoadjuvant therapy, remain overlap and puzzle sometimes. Moreover, because of the different therapy goals, the above three therapies are different in the selection of treatment methods, duration of therapy and evaluation criteria. Based on clinical practice, the authors investigate the progress and hot spots of the conversion therapy, preoperative neoadjuvant therapy and post-operative adjuvant therapy of HCC, expecting more clinical evidence-based medicine to standardize the development of comprehensive treatment, so as to become a breakthrough to improve the diagnosis and treatment of HCC.

Objective To investigate the induced expression of indoleamine 2,3-dioxygenase in epithelial cells of cultured human proximal renal tubule under the stimulation of interferon-?(IFN-?)in vitro.Methods The expression of IDOmRNA in epithelial cells of human proximal renal tubule under normal and different dosage or time of IFN-? stimulation were assayed by semi-quantitative RT-PCR,the expression of IDO protein under normal and 2000U/ml IFN-? stimulation for 24h were assayed by immunocytochemistry,and the activity of IDO under different dosage of IFN-? stimulation was assessed by the special kynurenine metabolizable ratio in culture medium detected by high performance liquid chromatography(HPLC).Results No expression of IDO mRNA or IDO was found in the epithelial cells of human proximal renal tubule under normal culture conditions.IDO mRNA expression increased significantly after IFN-? stimulation in a dose dependent manner compared with that of control group(P

Objective To discuss the cumulative effect of acupuncture on left ST40 to hemodynamic of PCA.Methods Sixteen healthy young people were randomly chosen to be acupunctured on left ST40 and parameters of TCD such as Vs,Vd,Vm,PI and RI were managed to be recorded sequentially at the 5 points below to make out an statistical analysis:10 min before acupuncture; the time of inserting the needles; 15 min after retaining the needles; the time when taking the needles out; 10 min after the acupunture.Results The parameters of TCD Vs,Vd,Vm 10min after withdrawing the needle [Were ( 84.56± 19.72) cm/s、( 39.75 ±10.15 ) cm/s、(56.13 ± 14.73 ) cm/s each] all showed a decline compared with the parameters 10min before acupuncture(P＜0.05),while other parameters turned out to be almost the same (P＞0.05).Conclusion Acupuncture on left ST40 has cumulative effect on Vs,Vd and Vm,which suggest us the needle retention time should be noted.

Objective To study the characteristics of lower respiratory tract infection by Streptococcus pneumonia in children aged from 0 to 5 years and drug resistance,so as to provide the rational basis for clinical treatment and epidemiology.Methods The medical data from 4 815 children aged 0 to 5 years with lower respiratory tract infection between September 2014 and September 2016 were retrospectively reviewed.Results Totally 343 strains of Streptococcus pneumonia were isolated from 4 815 sputum samples,with the isolation rate of 7.12％.Of the isolated streptococcus pneumonia strains,80.76％ were isolated from the children with pneumonia,9.33％ were isolated from the children with bronchitis,5.83％ were isolated from the children with capillary bronchitis,4.08％ were isolated from the children with bronchial asthma.There was no significant difference in the incidence of Streptococcus pneumonia infections between the genders of the children(P>0.05),but the incidence of Streptococcus pneumonia detection rates differed significantly in different seasons and children of different ages,the difference was statistically significant(P<0.05).The resistance rates of Streptococcus pneumonia to penicillin,erythromycin and clindamycin were 51.0％,97.9％ and 97.1％ respectively;The sensitivity rates to cefotaxime and vancomycin were 71.1％ and 100.0％ respectively.Conclusion The children aged less than 1 years old are at the high risk of Streptococcus pneumonia infection and highest detection rates in winter,it is necessary to perform the drug susceptibility testing in a timely manner so as to choice reasonable antimicrobial agents to control the condition.

Objective To understand the mechanism of vitamin A deficiency(VAD) impairing the mucosal immunity and the influences of VAD on cytokines response of intestinal mucosa in rats. Method The rat model with VAD was established,and intestinal infection was induced by typhoid salmonella orally administered. The fresh ileum tissue samples were taken,and ELISA and RT-quantity PCR were used to detect the production of cytokines,including IFN-?,IL-2,IL-4,IL-6,IL-10 and IL-12,by intestinal mucosa in protein and mRNA levels. Results IL-12,the cytokine produced by dendritic cells,was markedly increased in VAD rats,and the level was further raised when the VAD rats were complicated by intestinal infection. The Th1 cytokines,IFN-? and IL-2,were reduced in VAD rats. IL-4,the main Th2 cytokine,was significantly decreased after intestinal infection,especially in VAD rats. IL-6 mRNA was lower in VAD rats and after intestinal infection compared with that of the VA normal control. IL-10 mRNA was also declined in VAD rats,and more markedly reduced after intestinal infection. Conclusion The regulation of VAD onproduction of cytokines in local intestinal mucosa is likely to be an important mechanism of VAD affecting intestinal mucosal immunity.

Objective To investigate the expression of indoleamine 2,3-dioxygenase(IDO)in renal tissues of crescent nephritis and its correlation with cell proliferation and pathologic tubulointerstitial lesion.Methods Immunohistochemistry was used to detect IDO expression in renal tissues of crescent nephritis and normal renal tissues.The correlation between IDO expression and the number of proliferating cell nuclear antigen(PCNA)positive cells or pathologic tubulointerstitial lesion were analyzed.Results IDO expression was found in the renal tubular epithelial cells of crescent nephritis,while that in the normal renal tissues was negative by immunohistochemical staining.The expression of IDO protein in tubular epithelial cells showed a significantly negative correlation with the number of PCNA positive cells or tubulointerstitial lesion of crescent nephritis.Conclusion IDO may participate in the pathogenesis of crescent nephritis by inhibiting the cell proliferation.

Objective To investigate the value of CysC-based CFR in comparison with creatinine-based GFR (CG-GFR and MDRD-GFR) as an accurate serum marker in the prediction of early diabetic nephropathy. Methods A tatal of 133 type 2 diabetic patients (74 males and 59 females, aged 58.1 ±12.3) were enrolled. The level of diabetic nephropathy (normoalbuminuric, microalbuminuric and macroalbuminuric) was staged and estimated GFR based on serum creatinine and cystatin C(CysC) was calculated. The plasma clearance of Tc-DTPA, serum CysC, creatinine, BMI, HbA1c, serum lipid and blood pressure were measured. Results 99mTc-DTPA-GFR was used as golden standard. At 90 and 75 ml· min-1· (1.73 m2)-1 cut-points, diagnostic efficiencies of CysC-GFR (89% and 92%) were better than those of CG-GFR (79%=86%, P=0.004, 0.04) and MDRD-GFR (80%-86%, P=0.02, 0.04). At 60 ml · min-1 · (1.73 m2)-1 cut-point, diagnostic efficiencies of CysC-GFR,CG-GFR and MDRD-GFR were 92%, 90% and 92% respectively (P= 0.49, P=0.71). The Logistic regression analyses showed that retinopathy, HbA1c, CysC, diabetic duration, and CysC-GFR were indicators to predict the development of microalbuminuria. Conclusion CysC-GFR is more valuable than CG-GFR and MDRD-GFR in the prediction of early diabetic nephropathy and should be applied clinically.

Objective To investigate the expression change of renal NLR family pyrin domain containing-3 protein(NALP3) in-flammasome in the nephrotic syndrome(NS) patients with focal segmental glomerulosclerosis(FSGS) and its relation with the tubu-lointerstitial pathogenic injury degree ,expression of inflammatory factors and clinical biochemical indexes .Methods Immunohisto-chemistry was used to detect the expressions of NALP3/ASC/caspase-1 and their downstream effector molecule IL-1β,IL-18 in re-nal tubular epithelial cells .The tubulointerstitial injury score and the activated macrophages F4/80 in renal interstitium of the FSGS patients and NS patiens were evaluated .The serum creatinine ,urea ,total protein ,albumin ,24 h urine protein and estimated glomer-ular filtration rate(eGFR) were observed .The correlation of tubulointerstitial injury with NALP3/ASC/caspase-1 ,IL-1β,IL-18 were respectively analyzed .Results The expression of NALP3/ASC/caspase-1 ,IL-1β,IL-18 in the renal tissue of the FSGS pa-tients was significantly increased compared with that in the control group (P<0 .01) .NALP3/ASC/capspase-1 expression was pos-itively correlated with the expression of IL-1β,IL-18(P< 0 .01) .NALP3/ASC/caspase-1 ,IL-1β,IL-18 expression was positively correlated with renal tubulointerstitial injury and the F4/80 expression intensity(P<0 .01) .NALP3/ASC/caspase-1 ,IL-1β,IL-18 was significantly positively correlated with 24 h urine protein and Scr ,and negatively correlated with the eGFR (P<0 .05) ,but had no obvious correlation with plasma urea ,plasma total protein and albumin concentrations .Conclusion The NALP3 inflammasome might participate in the pathogenic mechanism of FSGS through the activation of its downstream inflammatory factor of IL-1β,IL-18 ,the more higher its expression degree ,the more severe the renal tissue injury ,whether which could be served as the warning in-dex needs the further clinical verification .

Objective To explore the safety and efficacy of hepatic resection with selective hepatic vascular exclusion(SHVE). Methods SHVE was used in 246 consecutive patients undergoing major or complex liver resection in our center. Preoperative demographic and clinical data,details of the surgical procedure, pathologic diagnosis, postoperative course and complications were collected and analy zed. Results From January 2000 to July 2007, liver resections were performed IJnder SHVE in 246 patients; total SHVE, right partial SHVE and left partial SHVE in 145, 54 and 47 patients, respectively. SHVE was converted to total hepatic vascular exclusion(THVE)in 3 patients to repair the wall of inferior vena cava(IVC). Hemodynamic tolerance to SHVE was excellent, only with a slight increase in systemic and pulmonary vascular resistance during clamping.There were no deaths. and the morbidity was 24.8%.The mean leyth of hospital stay was 9.6 days(range 8-18) .Conclusion Our study showed that SHVE is a safe and effective procedurei and it is applicable to liver tumors near but not invade the inferior vena cava.