The incidence of coIorectaI cancer is increasing in recent years. Liver metastasis is the main cause of death in patients with coIorectaI cancer. EarIy diagnosis and treatment of Iiver metastasis is important for improving the survivaI rate of patient. Liver metastasis in coIorectaI cancer is a muIti-step progress invoIving many genes and moIecuIar aIterations,detecting the abnormaI changes wiII heIp to assess the earIy risk of Iiver metastasis. This articIe reviewed the advances in studies on assessment of Iiver metastasis in coIorectaI cancer.

The subject of modernization of Traditional Chinese Medicine(TCM) has been argued in China for many years.Many good ideas have been suggested by experts and scholars.In this paper,one issue in the modernization of TCM is discussed.The issue is how to introduce some mathematical methods into traditional Chinese medicine.This is a valuable subject to study,because by this way,the computers can be used to analyze the composing methods of TCM prescriptions and to help TCM doctors to select better treating means.A new mathematical method for analyzing the composing methods of TCM prescriptions has been developed,and the methods are still based on TCM theory.By these methods,the TCM prescriptions can be computed or analyzed in digital formations,but the integral conception about human body in TCM is still left intact.In this paper,using the new method,several TCM prescriptions were analyzed,and the analyzed results demonstrate that the methods are efficient and give a good help to understand the composing methods of TCM prescriptions.

Gastrointestinal neuroendocrine tumor(GI-NET)originates from peptide neurons and neu-roendocrine cells in gastrointestinal tract,and secrets peptide hormones,leading to carcinoid syndrome which rarely happens in clinical practice. Because of the improvement of diagnostic method and understanding of this rare disease,the morbidity is rising in recent years. The main treatments of GI-NET are surgery and compre-hensive therapy,consisting of chemotherapy and targeted therapy.

Objective To estimate the diagnostic value of dual-energy CT in gouty arthritis.Methods English and Chinese litera-tures publicated before May 2014 were searched in PubMed,Embase,Cochrane and Wanfang database.Available literatures were selected according to the inclusion and exclusion criterias.Sensitivity,specificity with 95% confidence interval (95% CI)was pooled with bivariate random-effects model.Hierarchical weighted symmetric summary receiver-operating curve (HSROC)was also used in estimating.Meta-regression and sensitivity analysis were used to explore the potential sources of heterogeneity.Results Nine studies were included in the analysis.The pooled sensitivity,specificity and 95% CI were 92%(84-96%)and 88%(83-92%)respectively, area under the HSROC curve was 0.91 (0.88-0.93).There was substantial heterogeneity between studies(I 2 =85%).Conclusion Dual-energy CT is accuracy in diagnosing gouty arthritis.The sources of heterogeneity was not been explored.

Epithelial-mesenchymal transition is the phenomenon of epithelial cells transforming to mesenchymal cells under special microenvironment,and thus tumor cells obtain characters such as difficult to adhere,motility enhancement,resistant to apoptosis.In the process of embryonic growth and tumor development,epithelial cells were found to be transformed into mesenchymal cells.Many researches showed that epithelial-mesenchymal transition plays an important role during the invasion and metastasis of colorectal cancer,and its mechanism involves many kinds of signaling pathways and related molecules.

Objective To investigate the effects of different BIS values on postoperative cogni-tive dysfunction (POCD)and S100βprotein(S100β)in the early stage of postoperation.Methods Fifty patients who were scheduled for selective abdominal surgery under general anesthesia (male 34 cases, female 1 6 cases,aged 65 to 75 years,ASA Ⅰ or Ⅱ)were randomly divided into two groups:light anesthesia group (group L,n =25,BIS value was maintained at 50 to 59)and deep anesthesia group (group D,n =25,BIS value was maintained at 30 to 39).BP,HR,SpO 2 ,ECG,PET CO 2 ,inhaled anes-thetic concentration and BIS values were recorded on time points of 5 minutes after the patients ente-ring the operating room (T0 ),before endotracheal (T1 ),intubation (T2 ),incision (T3 ),two hours after incision (T4 ),three hours after incision (T5 )and at the end of surgery (T6 ).The procedure du-ration,anesthesia time,dosages of propofol,fentanyl,midazolam and VAS scores on 1 d after sur-gery were also recorded.Blood samples were collected on time points of 10 min before anesthesia,im-mediately after surgery and 24,48 h after operation.S100β concentration were detected.Mini-mental State Examination (MMSE)score and Trail Making Test (TMT)completion time were recorded on 1 d before surgery and 1,3,7 d after surgery.Results BIS value of group D were lower than group L on T2 ,T3 and T4 .The propofol dosage of group D was significantly greater than that in group L (P <0.05 ).The concentration of serum S100βincreased significantly immediate and 48 h after operation in both groups compared with 10 min before anesthesia(P < 0.05).It was still higher 24 hours after op-eration than before anesthesia.But there was no statistic difference.Compared with the end of surger-y,the concentration of serum S100βin two groups on 24 h after surgery were significantly decreased (P < 0.05 ).The concentration of serum S100β in group L on the end of surgery and 24 h after surgery were higher than that in group D significantly (P <0.05).Compared with 1 d before surgery, postoperative 1 d MMSE scores in two groups and postoperative 3 d MMSE score in group L de-creased significantly (P <0.01).Compared with postoperative 3 d,postoperative 7 d MMSE score in group L increased significantly (P <0.01).Postoperative 1,3 d MMSE score in group D were signifi-cantly higher than group L (P <0.05).Compared with 1 d before surgery,TMT completion time in two groups on 1 d after surgery were significantly prolonged (P <0.01 ).Compared with 1 d after surgery,TMT completion time in two groups on 3 d after surgery were significantly shortened (P <0.01).Compared with 3 d after surgery,TMT completion time in group L on 7 d after surgery was significantly shortened (P <0.01 ).TMT completion time in group D on 1,3 d postoperative were significantly shorter than group L (P <0.05).POCD incidence of group D on 1 d after surgery was lower than that in group L (P < 0.05).Conclusion Different depth of anesthesia can ensure hemo-dynamic balance in old patients during surgery and after surgery.When BIS value was maintained at 30 to 39,it had lower S100βprotein levels,lower incidence of early POCD and a lesser degree of post-operative cognitive dysfunction.

Objective To investigate the phenotype and the immunoregulatory function of CD8αα+TCRαβ+regulatory T cells in peripheral blood samples from mice.Methods The distribution profile and the phenotype of CD8αα+TCRαβ+regulatory T cells in C57BL/6 mice were detected by flow cytometry.The cytokines released by CD8αα+TCRαβ+regulatory T cells upon the stimulation with anti-CD3 antibody were analyzed by cytometric bead array.The in vitro immunosuppressive activity of CD8αα+TCRαβ+regulatory T cells on activated CD4+T cells was analyzed by using flow cytometry and carboxyfluorescein succinimidyl ester ( CFSE ) .An adoptive cell transfer assay was set up to evaluate the immunoprotective effects of CD8αα+TCRαβ+ regulatory T cells in a mouse model of experimental autoimmune encephalomyelitis ( EAE) .Results CD8αα+TCRαβ+regulatory T cells were detected in liver, spleen and peripheral blood samples collected from na?ve C57BL/6 mice.Compared with CD8αβ+TCRαβ+regulatory T cells, CD8αα+TCRαβ+regulatory T cells showed a memory-activated phenotype of CD25+CD122high CD44high CD62Llow CD69high NK1.1+DX5+.CD8αα+TCRαβ+regulatory T cells could produce IL-2 after 24 hours stimulation with anti-CD3 antibody, followed by producing IFN-γ, TNF-α, IL-4, IL-17A and traces of IL-6 and IL-10. In vitro, CD8αα+TCRαβ+regulatory T cells specifically suppressed the proliferation of activated CD4+T cells ( P<0.01 ).Moreover, they could delay the onset of EAE in mice and reduce clinical score (P<0.01).Conclusion CD8αα+TCRαβ+regulatory T cells were a unique population with immunoregula-tory function, which could be used as a potential therapeutic target in the treatment of autoimmune disease.

Promoting equity and access to medicine is important to guarantee health equity. The international communities commonly guarantee equity and access to medicine through free pharmaceutical policy. In most coun-tries, free pharmaceutical policy covers patients who cannot afford, children under 5, pregnant women and elderly people. The free medicines include essential medicines, medicines for chronic and infectious diseases, vaccines, etc. Financing of free medicines comes from health insurance, direct government investment and international aid, and the medicine delivery mainly depends on the public medical institutions. Free pharmaceutical policy in China mainly refers to medicines for infectious diseases and vaccines, and the coverage is narrow. This paper argues that since China has been becoming one of the middle income countries, the amount of free medicines should be in-creased, especially for chronic diseases, such as diabetes, hypertension, etc. The equity and access to medicine in China should be further promoted by providing all essential medicines for free.

Objective To study the protective effect of sufentanil preconditioning on hepatic ischemia-reperfusion injury in rats and to investigate the mechanisms whether may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphoryla-tion .Methods Thirty SD rats(in either gender ,weighing 220-270 g) were randomly divided into five groups :Sham-operated group (Ⅰ) ,ischemia-reperfusion group(Ⅱ);sufentanil preconditioning group(5 μg/kg ,Ⅲ) ,SB203580(an inhibitor of p38 MAPK) group (Ⅳ) ,and dimethyl sulphoxide (DMSO) control group(Ⅴ) .Sample specimens were collected from each group at 240 minutes after reperfusion .Serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were measured by an automatic biochem-ical analyzer .Malondialdehyde(MDA) and superoxide dismutase(SOD) in liver tissue was measured .HE staining was used to ob-serve the hepatic pathological changes ,and to examine the expression of phosphor-p38 mitogen-activated protein kinases (p-p38 MAPK)of hepatic tissues by western blotting .Results Compared with group Ⅰ ,levels of AST ,ALT and MDA showed signifi-cantly increased in group Ⅱ-Ⅴ ,but levels of SOD decreased ,and obvious pathological changes were observed in the liver .In GroupⅢ significantly decreased the elevated levels of ASL ,ALT and MDA but increased levels of SOD ,and lessened hepatic pathological changes ,caused promoted p38 MAPK phosphorylation at 240 minutes after reperfusion .The protective effects of sufentanil precon-ditioning were abolished by SB203580 pretreatment .There were no significant differences between group Ⅴ and group Ⅱ .Conclu-sion Sufentanil preconditioning can reduce the hepatic ischemia-reperfusion injury .The protective mechanisms may be by activating p38 MAPK signal pathway to promote p38 MAPK phosphorylation .

Objective To investigate the clinicopathological factors related with the lymph node ratio (LNR) in colorectal cancer patients.Methods The clinical and pathological data of 177 colorectal cancer patients who were treated by surgery in Shanghai Jiao Tong University Affiliated Sixth People's Hospital from January 2011 to December 2013 were collected.The association between LNR and clinicopathological factors were evaluated by single factor analysis nsingx x2 test.Results Gender,age,tumor location,tumor size,gross type,depth of infiltration,infiltration extent around bowel wall and preoperative serum CA199 concentration were not related with LNR (P ＞0.05),but tumor histological type,tumor differentiation,preoperative serum CEA,CA125 concentration were related with LNR (P =0.001,0.004,0.004,0.025).Conclusions Tumor histological type,tumor differentiation,preoperative serum CEA,CA125 may be the important factors related with LNR in colorectal cancer.