Currently,as various liver cancer-related treatments in China become developed,doctors also become super-subspecialized.This results in the doctors having more specialized skills and knowledge but a narrower vision.There is a tendency for these super-subspecialists to think and to make decisions based on a narrow perspective.As a consequence,interdisciplinary collaboration is becoming difficult.This hinders further improvement of treatment of liver cancer which has reached a plateau for many years.The present paper proposes a systematic perspective in decisionmaking for treatment of liver cancer.There are seven aspects which include the basic nature of medical care,the history of development of treatment,liver anatomical and functional characteristics,multicentric tumour occurrence,pathology,tumor immunology and biology.We aim to broaden the doctors’ vision and optimize their clinical thinking process.

Objective To determine 2, 3, 4, 5, 6-pentafluorobenzyl monofluoroacetate (PFB-MFA) as the derivative of monofluoroacetate anion ion by gas chromatography, by which fluoroacetamide, one of the raticides may be analyzed. Methods The calibration curve and limit of detection were obtained by quantification of standardized PFB-MFA using GC/ECD and GC/MS. Results The linear ranges for PFB-MFA were 0.01～0.1ng/?for GC/ECD,1～100ng/?l for GC/MS SCAN and 5?10~(-3)～1 ng/?l for GC/MS SIM. The limit of detections for fluoroacetate anoin were 1.31?10~(-4)ng/?l for GC/ECD, 0.13 ng/?l for GC/MS SCAN, and 1.76?10~(-4) ng/?l for GC/MS SIM. Conclusion The monofluoroacetate anion derivative (MFAPFB) can be deterimined accurately with high sensitivity by GC/ECD and GC/MS SIM, which may be used for analysis of fluoroacetamide in forensic practice.

Objective To explore therapeutic efficacy of blue-light-filtering intraocular lenses implantation on treating patients with diabetes cataract , and provide a more comfortable choice after phacoemulsification ( PHACO) and intraocularlens ( IOL) implan-tation.Methods A total of 100 cases (100 eyes) of patients with diabetes cataract was collected , and was randomly divided into group I ( n =50, implanted ordinary intraocular lenses ) and group II ( n =50, implanted blue-light-filtering intraocular lenses).Af-ter surgery, the best-corrected vision and postoperative complications were reported .The subjective visual performance was evaluated by questionnaire .Results At 1 week and 1 month after surgery , the best-corrected vision had no significant differences between two groups ( P >0.05 ) .Early complication after surgery was not significantly different between two groups ( P >0.05 ) .The subjective visual performance in the blue-light-filtering intraocular lenses group was significantly better than that in the ordinary intraocular lenses group ( P <0.05 ) .Conclusions When the blood sugar is controlled in certain level , it is possible for the blue-light-filtering in-traocular lenses to provide a better choice for patients with diabetes cataract .

Gastroenteropancreatic neuroendocrine carcinoma (GEP-NEC) is a rare and poorly differentiated tumor with poor prognosis. Although radical surgical treatment is the most preferred treatment for GEP-NEC, postoperative recurrence rate is still high. Many patients diagnosed at the late stage lost the chances to receive the surgery treatment. Therefore, systemic chemotherapy plays a particularly important role in the comprehensive treatment of GEP-NEC. The purpose of this paper is to systematically summarize and review the research progress of GEP-NEC systemic chemotherapy.

Indoleamine 2,3-dioxygenase (IDO) is a kind of immune regulation enzyme.IDO is the only rate-limiting enzyme that can catalyze the oxidative clearage of indole ring in tryptophan and its catabolism along the kynurenine pathway.IDO1 is one of the important mechanisms in maternal immune tolerance,which participates in the regulation of maternal-fetal immune relationship.The newly discovered IDO2 also plays an important role in this relationship.The abnormal expression of IDO2 is associated with the male infertility.

To optimize Chinese hamster ovary (CHO)expression system and establish a process of screening CHO cell lines with high productivity;neomycin-phosphotransferase (NPT)expressed by the resistance marker gene on the expression vector was mutated with amino acid D at 261 changed to G.After selection by culturing with G418;the survival rate of CHO cells bearing mutant-NPT was significantly lower than that of the cells bear-ing wide type NPT.An enhanced green fluorescent protein (EGFP)was genetically linked to the N terminus of the IgG1 Fc fragment part to generate an EGFP-Fc fusion protein regarded as a report gene;which verified that the resistance of mutant-NPT to G418 was weakened.By comparing fluorescence assay of EGFP intensity in stable transfections after selection with the same concentration of G418 for 3 weeks;mutant-selected pools expressed more exogenous protein than the WT-selected pools.Therefore;the ratio of high producers in a transfected cell population greatly increased.

Objective To detect the expression of p16 and discuss the significance in genesis and development of cervical cancer. Methods FQ-PCR method was used to detect the expression levels of p16 mRNA in cervical cancer(CC),cervical intraepithelial neoplasia(CIN),and normal tissues.And in situ hybridization was used to detect HR-HPV in these tissues.Results The expres-sion levels of p16 were 0.79±0.34,0.70±0.36,0.26±0.21 in CC,CIN and normal cervical tissues,respectively.The difference was significant (P <0.05).The expression level of p16 was significantly associated with FIGO stage (P <0.05),but it showed no significant relationship with age,tumor size,cell differential degree and lymphoid node metastasis (P >0.05).The expression level of p16 in HR-HPV positive cases was significantly higher than that in HR-HPV negative cases (P <0.05).Conclusion p16 shows high expression level in cervical cancer,which is closely related to the infection of HR-HPV infection.It suggests that the high ex-pression of p16 play an important role in genesis and development of cervical cancer.

Objective To investigate concentration of plasma neutrophil gelatinase -associated lipocalin ( NGAL) and its clinical significance in ICU populations with sepsis.Methods Fourteen ICU patients diagnosed with sepsis and twenty-four patients with non-sepsis were enrolled in the study,and seventeen healthy adults were selected as healthy control.Blood samples were drawn from patients to measure NGAL, and Acute Physiology and Chronic Health Evaluation ( APACHE ) II and Sequential Organ Failure Assessment ( SOFA ) were performed, the outcome was recorded.Plasma NGAL concentration was measured by enzyme -linked immunosorbent assay ( ELISA) .Results On admission to ICU, the pNGAL concentrations of septic and non -septic patients were (131.4 ±116.4)ng/mL and (48.7 ±30.8)ng/mL respectively,which of healthy control was (39.07 ±12.74)ng/mL.The pNGAL was significantly higher in sepsis than non-sepsis and healthy control ( t=-3.280,3.313,P=0.003,0.021 respectively).Otherwise,no differences of white blood cell (WBC) count [(12.6 ±5.7) ×109/L vs (15.6 ±5.8) ×109/L] and SOFA scores [(7.7 ±3.3)points vs (8.6 ±3.4)points] were found in septic and non-septic patients (t=-1.554,-0.802,P=0.129,0.428).On the admission to ICU,areas under the receiver oper-ating characteristic curves ( ROC curves) of NGAL and WBC for predicting sepsis were 0.740 [95%confident inter-val(CI) 0.566,0.913,P =0.015] and 0.345 ( 95%CI 0.158,0.533,P =0.116) respectively.If pNGAL of 99.4ng/mL as the threshold for predicting sepsis, the sensitivity and the specificity was 50.0% and 85.2%. Conclusion The concentrations of NGAL in septic patients significantly increased compared with that in non-sepsis and in healthy adults.And the NGAL levels maybe another sensitive biochemical marker for predicting infection.

Objective To explore the application value of interferon gamma release assay (IGRAs)in the clinical detection of tuberculosis infected T lymphocytes.Methods Used IGRAs method to detect the 11 968 outpatients and hospitalized pa-tients from 2013 to 2016 with tuberculosis screening.According to the distribution department analysis,also of positive case detection according to age and gender were analysis and comparison and analysis on the uncertainty of results,different methods were compared.Results Among the 11 968 cases,2 048 cases were positive,the positive rate was 17.11%,and the uncertain result was 107 cases,which accounted for 0.89% of the total number.The positive rates from 2013 to 2016 were 19.65%,21.35%,15.82% and 13.56%,respectively.In the detection and screening of pulmonary and pulmonary tuberculo-sis,the positive rates of the department of respiration,the digestive department,the oncology department,the department of neurology and the department of gynecology were 22.07%,20.27%,23.38%,12.84% and 11.86%,respectively.In the positive screening,men accounted for 62.11%,women accounted for 37.89%,men were significantly higher than women.By age group,was less than or equal to 15,16~25,26~45,46~65,was more than orequal to 66 years old,positive rate were 1.96%,18.51%,16.54%,21.25% and 25.73%,respectively.Analysis of uncertain outcome data,department of respira-tion,rheumatism,department of hematology,accounted for 1.99% and 2.35%,respectively.Compared with other laboratory methods,the IGRAs method had obvious advantages.Conclusion Tuberculosis occurs in various body organs,there were differences in gender and age of Mycobacterium tuberculosis infection.IGRAs is a sensitive and specific method for rapid de-tection of Mycobacterium tuberculosis infection,although it can not be used as a diagnostic indicator,but in patients with suspected tuberculosis IGRAs has a larger clinical application value for the further diagnosis of disease.

Objective To investigate the diagnostic value of the single detection and combined detection of Epstein-Barr virus (EBV) VCA-IgM ,aspartate transaminase (AST) and alanine transaminase (ALT) in EBV current infection .Methods The VCA-IgM positive simples tested by chemiluminescence from January to October 2016 were collected .EBV-DNA was detected by RT-PCR .AST and ALT were detected by using the enzyme rate method .Then samples were divided into the EBV-DNA positive group and EBV-DNA negative group .SPSS22 .0 was used for conducting the non-parametric test .Then each indicator was analyzed by the Logistic regression and receiver operating characteristic (ROC) curve .Results The levels of VCA-IgM ,AST and ALT in the EBV-DNA positive group were higher than those in the EBV-DNA negative group ,the difference was statistically significant (P<0 .05) . VCA-IgM ,AST and ALT showed a correlation with EBV-DNA (P<0 .05) .The areas under curve (AUC) of VCA-IgM ,AST and ALT single indicator detection curve were 0 .803(95% CI:0 .735 -0 .872) ,0 .788(95% CI:0 .708 -0 .868) ,and 0 .752(95% CI:0 .671-0 .832) ,respectively ;AUC of 3-indicator combined detection were 0 .830(95% CI:0 .765 -0 .896) ,which was high than AUC of each single indicator detection .Conclusion Among the indicators in EBV current infection ,VCA-IgM is of great diagnostic value ,and is superior to AST or ALT .Furthermore ,the combined detection of these three indicators is better than single indicator detection ,which contributes to the diagnosis and prevention of EBV infection and other complicating infection .