Because of the lymphatic drainage of the neck area level-Ⅰb of nasopharyngeal carcinoma is particular,and skip metastasis in the cervical lymph node is rare,the involved region of level-Ⅰb lymph node metastasis rate is low in nasopharyngeal carcinoma.In the three-dimensional radiotherapy era of precision radiotherapy,there is no consensus on whether level-Ⅰb need to be prophylactic irradiated in the clinic.

Objective To review the effect of endothelial cells in the tumoral invasion miroecosystem(TIMES) and the progress of recent research in this field. Methods The relative references of TIMES, including investigative background, main components, differences compared with the tumor microenvironment, and effect of endothelial cell are studied systematically. Results The TIMES is considered as a naturally integreted functional unit which is composed of cell communities and host environment during the process of tumoral cells invading, it is an ecosystem at both cellular and molecular level. Being different from TIMES, the term of tumoral microenvironment means the environment conditions for the existence of tumor cells, it is a kind of constructive system, not including tumor cell itself, and not possessing the regulation of ecosystem. The main elements of TIMES include tumor cell communities, host cell communities, and their enviroment(extracellular matrix), among them the endothelial cell communities are the most important host communities. The main effect of endothelial cells on the TIMES is the trophic links between tumor cell communities and endothelial communities, which froms a material cycle, including nutritional and matrix cycyles. The tumoral invasion and metastasis result from the continuous rebuilding of trophic links between tumor cell communities and endthelial cell communities.Conclusions The endothelial cell regulates TIMES by its trophic links with tumor cell communities. To block the links between tumor cell communities and endothelial cell communities might be the one of the key factors in tumoral treatment.

[Objective] To investigate the anatomical relation between manubrium sternum incisure(MSI)with the level of upper thoracic vertebrae(UTV)and to find out the basis of operative approach of UTV.[Method]Standing pan chest radiographs of 400 male and 400 female were equally divided into 4 year groups:≤19 years,20～39 years,40～59 years and ≥60 years and were used to observe the relationship between MSI with the level of UTV.On the basis of this relationship,a suitable UTV approach was advocated.There were fracture and dislocation of UTV 7 cases,UTV tumor 9 cases,tuberculosis of UTV 3 cases;OPLL ossification of UTV 2 cases.Diseases located at T1 6 cases,T2 7 cases,T3 2 cases,T4 3 cases,T1、2 2 cases,T2、3 1 case.Lower anterior cervical approach was performed for 7 cases including T1、2 one case and T2 one case,improved T3 1 case,and right subscapular transthoracic posterolateral approach was used for 5 cases.[Result]The number of UTV in relationship with the level of MSI was successively increased from T1 to T3 and was gradually decreased on T4,i.e.rate of cases of level of MST in relationship with T1、2 level was 1%,to T2 level 5.5%,to T2、3 level 15.87%,to T3 level 43.5%,to T3、4 level 20.75%,to T4 13.375%.No relationship was found in trend of distribution with the age and gender.The operative approach of UTV according its relationship with MSI was performed with the advantages of satisfactory exposure easily manipulation and satisfactory clinic results in most follow-up cases.One case died of metastasis of tumor in 9 months,3 cases were complicated with cerebrospinal fluid leakage and 3 cases with injury of recurrent laryngeal nerve.[Conclusion]Approach to UTV should be selected according to its relationship between MSI and diseased UTV preoperatively.The operative approach of UTV according to its relationship with MST has the advantages of satisfactory exposure,easily manipulation and satisfactory clinic results.

Objective To evaluate the possible roles of IL-4,IL-18 in hepatitis B virus (HBV) infection.Methods Serum IL-4,IL-18 level was measured using ELISA,and serum HBV-DNA content was detected by FQ-PCR.Results There was significant in serum IL-4,IL-18 level between the fulminant hepatitis patients and chronic hepatitis patients or normal controls (P

The correlation between the expression of COX-2 and p53 protein in basal cell carcinoma (BCC) of eyelid and apoptosis was investigated. Specimens of BCC were collected from 40 cases (aged 28-68 y) at the Department of Pathology, Renmin Hospital of Wuhan University, and Department of Pathology, Zhongnan Hospital of Wuhan University during from 1999 to 2006. Five specimens of paracancerous tissues served as control group. Immunohistochemical staining was performed to detect the expression of COX-2 and p53 in the tissues. The average absorbance (A) and the average positive area rate of COX-2 and p53 protein were measured by image analysis. The positive area rate of COX-2 and p53 protein was analyzed by linear correlation analysis. It was found that COX-2 and p53 proteins were highly expressed in BCC of eyelid, and weakly expressed in paracancerous tissues. Image analysis revealed that the expression of COX-2 and p53 proteins in BCC of eyelid was significantly higher than that in paracancerous tissues (P<0.01). Spearman rank correlation analysis demonstrated a positive correlation between the expression of COX-2 and p53 (r=0.113, P=0.421). It was concluded that COX-2 can increase the expression of p53 protein, therefore suppressing apoptosis.
Apoptosis ; Carcinoma, Basal Cell/*metabolism ; Cyclooxygenase 2/*metabolism ; Eyelid Neoplasms/*metabolism ; Tumor Suppressor Protein p53/*metabolism

The crux of medical moral education into training the medical moral concept of medical students. From psycholgical aspect,this paper analyzes the levels and structures of medical concept,and suggests its corresponding training method.

Objective To investigate the level Ⅰb contouring,dose analysis and regional recurrence in level Ⅰb lymph node-negative (Ⅰb-negative) nasopharyngeal carcinoma (NPC) patients treated by intensity-modulated radiotherapy (IMRT).Methods One hundred ninety newly-diagnosed,Ⅰb-negative NPC patients treated by IMRT were enrolled.Level Ⅰb contouring and dose prescribing in this cohort were classified into planned prophylactic irradiation (PPI) group (56 cases) and non-planned prophylactic irradiation (non-PPI) group (134 cases).The mean dose (Dmean) of the level Ⅰb bilaterally and submandibular glands (SMGs) was recorded for comparison.Results After a median follow-up of 47 months,there was no level Ⅰb regional recurrences noted in the entire group.The mean doses of level Ⅰb and the submandibular glands were significantly lower in the non-PPI group than those in the PPI group as follows:(50.81±5.37) Gy vs (59.68±3.32) Gy for the left level Ⅰb,(51.55±5.02) Gy vs (59.66±3.85) Gy for the left submandibular gland,(51.55±5.02) Gy vs (59.66±3.85) Gy for the right level Ⅰb and (57.25±4.69) Gy vs (63.41±2.88) Gy for the right submandibular gland (all P =0.000).Conclusion In this retrospective analysis of non-randomized single institute data,it seems unlikely that PPI to level Ⅰb is necessary in Ⅰb-negative NPC patients treated by IMRT.

Objective To explore the imaging characteristics of hepatic primary leiomyoma.Methods The CT and MR imaging findings of three pathologically proven primary leiomyoma of the liver were analyzed,and the correlation between the imaging features and pathological results was analyzed.Two patients underwent CT scanning.Two patients underwent MRI.Results The lesions appeared hypodense in CT images,and with elongated T_1 time and elongated T_2 time in MRI.One lesion was homogenous both in CT and MRI,with significant homogenous enhancement.The other two lesions were inhomogeneous,with inhomogeneous enhancement in one lesion.All the three lesions had the sign of pseudocapsule.Neither hepatic cirrhosis nor venous tumor emboli were present.Pathological examination showed proliferation of spindle- shaped neoplastic cells and hyperplasia of capillary.One tumor had central hyalinization and another tumor had central necrosis.Conclusion Primary leiomyoma of the liver is one kind of hypervascular tumors with pseudocapsule.CT and MR can provide helpful information to the diagnosis.

0\^05). Conclusion MMP\|2 and MMP\|9 may serve as indicators of invasion and malignant phenotype.Neither of them can represent the phenotype of metastasis,but both can represent that of matrix degradation.Moreover,MMP\|9 may play more important role in glioma invasion than does MMP\|2.

Objective: To determine phellodendrine in Cortex Phellodendri by HPLC. Methods : HPLC condition consists of C 18 column (Phenomenex, 150mm, 5?), actonitrile:250mL of 0.05mol?L -1 phosphoric acid +0.4mL of diethylamine (9∶91, v/v) as mobile phase, detection wavelength at 284nm. Results : The averagy recovery of phellofendrine was 101.43% ( RSD =1.56%, n =5) and the linear range of phellodrine was 0.4368～2.1840?g??L -1 , r =0.9998. Conclusion : The method is simple, accurate and reproducible, and can be used for the determination of phellodendrine in Cordex Phellodendri.