Objective:To explore how benzydamine (BA) improves brain edema in mice after cerebral ischemia-reperfusion.Methods:(1) One hundred and twenty 8 week-old male C57BL/6 mice were randomly divided into a sham-operated group, a middle cerebral artery occlusion (MCAO) group, a MCAO+low-dose BA group (L-BA group), and a MCAO+high-dose BA group (H-BA group), with 30 mice in each group. MCAO models in mice of the later 3 groups were established by suture method, while mice in the sham-operated group underwent the same surgical procedure without MCAO. At 6 hours after modeling, mice in the L-BA group and H-BA group were intraperitoneally injected with 5 mg/kg or 10 mg/kg BA, respectively, once daily for 3 days, while mice in the shamoperated group and MCAO group were intraperitoneally injected with same volume of normal saline instead. Dynamics of cerebral perfusion were monitored by laser speckle imaging in MCAO model mice at baseline, during occlusion, and following reperfusion. Three days after modeling, neurological deficits were assessed by modified neurological severity score (mNSS), neurological function was evaluated by forelimb grip strength and rotarod tests; cerebral infarct size was detected by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and neuronal death was assessed by Fluoro-Jade B staining; cerebral edema was quantified by dry-wet weight method, blood-brain barrier (BBB) permeability was assessed by Evans blue dye extravasation, and expressions of tight junction proteins (Claudin-5, zonula occludens-1 [ZO-1]) were detected by immunofluorescent staining; expressions of neutrophil extracellular traps (NETs)-related proteins (citrullinated histone H3 [citH3], myeloperoxidase [MPO] and matrix metalloproteinase 9 [MMP-9]) were determined by Western blotting. (2) Bone marrow neutrophils were extracted from male C57BL/6 mice and randomly divided into a control group, a phorbol 12-myristate 13-acetate (PMA) group, and a PMA+BA group; neutrophils in the PMA group were stimulated with PMA (50 nmol/L), while neutrophils in the PMA+BA group were co-treated with 50 nmol/L PMA and 50 μmol/L BA; and those in the control group were given an equal amount of dimethyl sulfoxide. Sytox Green staining was used to detect the NETs proportion in neutrophils.Results:(1) Baseline cerebral perfusion was robust (1 237.75±98.16 PU), which was markedly reduced during occlusion (297.36±77.63 PU) in the ipsilateral middle cerebral artery territory, and improved following reperfusion (939.21±73.63 PU). Compared with the MCAO group, mice in the L-BA group and H-BA group had lower mNSS score, increased paw grip strength, prolonged rotarod retention time, reduced infarct size, fewer neuronal death, lower brain tissue water content, reduced blood-brain barrier permeability, increased fluorescent intensities of Claudin-5 (0.51±0.11, 0.71±0.04, and 0.83±0.05) and ZO-1 (0.43±0.09, 0.65±0.05, and 0.81±0.03), and decreased protein expressions of citH3 (2.33±0.15, 1.92±0.03, and 1.42±0.04), MPO (2.14±0.08, 1.71±0.06, and 1.37±0.03) and MMP-9 (2.62±0.09, 1.83±0.06, and 1.41±0.05), with significant differences ( P<0.05). All the above changes in the H-BA group were more significant than those in the L-BA group ( P<0.05). (2) Compared with that in the control group (10.00%±8.00%), the proportion of NETs formation per field in both PMA group (85.33%±2.08%) and PMA+BA group (58.46%±5.29%) was significantly increased ( P<0.05); the PMA+BA group showed a significant reduction in NETs formation compared with the PMA group ( P<0.05). Conclusion:BA can alleviate cerebral edema in mice after cerebral ischemia-reperfusion, and its mechanism may be involved in inhibiting NETs formation.

Objective:To investigate the effect of nefazodone on excessive activation of microglia and its regulatory mechanism, as well as its effect on neurological injury in mice subjected to middle cerebral artery occlusion (MCAO).Methods:(1) BV2 cell line was routinely cultured in vitro, and primary microglia from the cortex of neonatal C57BL/6J mice were cultured. Cell counting kit-8 (CCK-8) assay was employed to assess the effects of nefazodone (0, 10, 20, 30, 50 μmol/L) on viability of BV2 cells and primary microglia to determine the working concentration. BV2 cells and primary microglia were divided into a normal control group, a lipopolysaccharide (LPS) group, and a nefazodone group; cells in the nefazodone group were pretreated with 20 μmol/L nefazodone for 2 h; cells in the LPS group and nefazodone group were stimulated with LPS (0.5 μg/mL for BV2 cells and 0.1 μg/mL for primary microglia) for 24 h; cells in the normal control group received an equivalent volume of solvent. Immunofluorescent staining was used to detect the expressions of ionized calcium-binding adapter molecule 1 (Iba1) and CD68. Reverse transcription quantitative PCR (RT-qPCR) was performed to measure interleukin ( IL) -1β, IL-6, tumor necrosis factor-α ( TNF-α), nitric oxide synthase 2 ( Nos2), C-C motif chemokine ligand 2 ( CCL2), and β-hexosaminidase subunit β ( Hexb) mRNA expressions. ELISA was used to quantify the concentrations of supernatant IL-1β, IL-6, and TNF-α in BV2 cells. Western blotting was applied to detect the protein expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in BV2 cells. Griess reagent assay was used to measure supernatant nitric oxide (NO) level in BV2 cells. Western blotting was also used to assess the protein expressions of extracellular signal-regulated kinase (ERK), phosphorylated (p)-ERK, c-Jun N-terminal kinase (JNK), p-JNK, p38, p-p38, nuclear factor kappa B p65 and p-p65 in BV2 cells. (2) Thirty male C57BL/6J mice were randomly divided into a normal control group, a MCAO group, and a nefazodone group, with 10 mice in each group. MCAO model in the MCAO group and nefazodone group was established using suture method; the nefazodone group received an intraperitoneal injection of nefazodone (15 mg/kg) 30 min after modeling, while the normal control group received an equivalent volume of solvent. Three days after modeling, neurological deficits were evaluated using modified neurological severity score (mNSS), and behavioral changes were evaluated by paw grip strength test and foot-fault test. Cerebral infarction volume was assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Iba1 protein expression in the ischemic penumbra was detected by Western blotting. Results:(1) CCK-8 assay showed no significant difference in viability of BV2 cells between the normal control group and 10 or 20 μmol/L nefazodone groups ( P>0.05), and viability of BV2 cells in 30 and 50 μmol/L nefazodone groups was statistically lower than that of normal control group ( P<0.05). Immunofluorescent staining revealed that compared with the normal control group, the LPS group had significantly increased fluorescent intensities of CD68 and Iba1; compared with the LPS group, the nefazodone group had significantly decreased fluorescent intensities of CD68 and Iba1 ( P<0.05). RT-qPCR results indicated that compared with those in the normal control group, the Nos2, CCL2, IL-1β, IL-6, and TNF-α mRNA expressions in both BV2 cells and primary microglia of the LPS group were significantly increased; compared with the LPS group, the nefazodone group had significantly decreased CCL2, IL-1β, and IL-6 mRNA expressions in BV2 cells, and significantly decreased Nos2, CCL2, IL-1β, IL-6, and TNF-α mRNA expressions in primary microglia ( P<0.05). ELISA showed that compared with those in the normal control group, the supernatant IL-1β, IL-6, and TNF-α levels significantly increased in the BV2 cells of LPS group; compared with those in the LPS group, supernatant IL-1β, IL-6 and TNF-α levels statistically decreased in the nefazodone group ( P< 0.05). Western blotting demonstrated that compared with those in the normal control group, the iNOS and COX-2 protein expressions significantly increased in BV2 cells of the LPS group ( P<0.05); compared with those in the LPS group, the iNOS and COX-2 protein expressions in BV2 cells of the nefazodone group statistically decreased ( P<0.05). Griess assay showed that compared with the normal control group, BV2 cells in the LPS group had significantly increased supernatant NO concentration ( P <0.05); compared with the LPS group, BV2 cells in the nefazodone group had significantly decreased supernatant NO concentration ( P<0.05). Western blotting revealed that compared with those in the normal control group, the p-ERK/ERK and p-JNK/JNK ratios significantly increased in BV2 cells of the LPS group ( P<0.05); compared with the LPS group, the p-p65/p65, p-ERK/ERK and p-JNK/JNK ratios significantly decreased in BV2 cells of the nefazodone group ( P<0.05). (2) Behavioral tests showed that compared with the normal control group, the MCAO group had significantly decreased forelimb grip strength and increased foot-fault rate ( P<0.05); compared with the MCAO group, the nefazodone group had significantly decreased mNSS score, increased forelimb grip strength and decreased foot-fault rate ( P<0.05). The percentage of cerebral infarction volume in the nefazodone group was significantly lower than that in the MCAO group ([9.56±1.81]% vs. [21.71±12.26]%, P< 0.05). The MCAO group had statistically higher Iba1 protein expression in ischemic penumbra (7.27±2.88) than the normal control group (1.00±0.64), and the nefazodone group had significantly lower Iba1 protein expression in ischemic penumbra (1.75±0.86) than the MCAO group ( P<0.05). Conclusion:Nefazodone can improve neurological function impairment in MCAO mice by inhibiting the excessive activation of microglia; cytological experiments suggest that its mechanism may be related to the negative regulation of ERK/JNK/NF-κB p65 signaling axis.

Objective:To establish an arsenic free fully automatic online digestion iodine analyzer detection method for urinary iodine (hereinafter referred to as the method).Methods:Based on the principle of iodine catalyzed antimony cerium redox reaction, a fully automatic online digestion iodine analyzer was used to determine the iodine content in urine. The effectiveness of the method in terms of detection limit, precision, accuracy (determination of urinary iodine primary standard reference materials GBW09108z and GBW09110f and spiked recovery experiment), and interference experiments was validated. The method was compared with the arsenic cerium catalytic spectrophotometry method recommended by the National Reference Laboratory for Iodine Deficiency Disorders.Results:The linear range of the method was 0 - 300 μg/L, with a correlation coefficient │ r│> 0.999 5. The qualitative and quantitative detection limits were 7.41 and 18.01 μg/L, respectively. The relative standard deviation ( RSD) of urine samples with different iodine concentrations ranged from 1.0% to 1.7%. The results of the determination of iodine concentrations in urine using standard substances GBW09108z and GBW09110f were within the given standard range, with RSD < 2.5%. The range of spiked recovery rates for urine samples with different iodine concentrations was 101.3% to 104.8%, with an overall average spiked recovery rate of 103.0%. The average concentration of the baseline iodine standard solution was determined to be 116.21 μg/L, and the relative error of the concentration determination with the addition of interfering substances was less than 5.0%. The comparison results showed that there was no statistically significant difference in the measurement results between the two methods ( t = - 0.06, P = 0.952). Conclusions:The method adopts automated detection, which is simple to operate, labor-saving, and does not require the use of arsenic trioxide. It has high precision and accuracy, and is suitable for detection of large quantities of samples.

Objective:To establish an arsenic free fully automatic online digestion iodine analyzer detection method for urinary iodine (hereinafter referred to as the method).Methods:Based on the principle of iodine catalyzed antimony cerium redox reaction, a fully automatic online digestion iodine analyzer was used to determine the iodine content in urine. The effectiveness of the method in terms of detection limit, precision, accuracy (determination of urinary iodine primary standard reference materials GBW09108z and GBW09110f and spiked recovery experiment), and interference experiments was validated. The method was compared with the arsenic cerium catalytic spectrophotometry method recommended by the National Reference Laboratory for Iodine Deficiency Disorders.Results:The linear range of the method was 0 - 300 μg/L, with a correlation coefficient │ r│> 0.999 5. The qualitative and quantitative detection limits were 7.41 and 18.01 μg/L, respectively. The relative standard deviation ( RSD) of urine samples with different iodine concentrations ranged from 1.0% to 1.7%. The results of the determination of iodine concentrations in urine using standard substances GBW09108z and GBW09110f were within the given standard range, with RSD < 2.5%. The range of spiked recovery rates for urine samples with different iodine concentrations was 101.3% to 104.8%, with an overall average spiked recovery rate of 103.0%. The average concentration of the baseline iodine standard solution was determined to be 116.21 μg/L, and the relative error of the concentration determination with the addition of interfering substances was less than 5.0%. The comparison results showed that there was no statistically significant difference in the measurement results between the two methods ( t = - 0.06, P = 0.952). Conclusions:The method adopts automated detection, which is simple to operate, labor-saving, and does not require the use of arsenic trioxide. It has high precision and accuracy, and is suitable for detection of large quantities of samples.

Objective:To explore how benzydamine (BA) improves brain edema in mice after cerebral ischemia-reperfusion.Methods:(1) One hundred and twenty 8 week-old male C57BL/6 mice were randomly divided into a sham-operated group, a middle cerebral artery occlusion (MCAO) group, a MCAO+low-dose BA group (L-BA group), and a MCAO+high-dose BA group (H-BA group), with 30 mice in each group. MCAO models in mice of the later 3 groups were established by suture method, while mice in the sham-operated group underwent the same surgical procedure without MCAO. At 6 hours after modeling, mice in the L-BA group and H-BA group were intraperitoneally injected with 5 mg/kg or 10 mg/kg BA, respectively, once daily for 3 days, while mice in the shamoperated group and MCAO group were intraperitoneally injected with same volume of normal saline instead. Dynamics of cerebral perfusion were monitored by laser speckle imaging in MCAO model mice at baseline, during occlusion, and following reperfusion. Three days after modeling, neurological deficits were assessed by modified neurological severity score (mNSS), neurological function was evaluated by forelimb grip strength and rotarod tests; cerebral infarct size was detected by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and neuronal death was assessed by Fluoro-Jade B staining; cerebral edema was quantified by dry-wet weight method, blood-brain barrier (BBB) permeability was assessed by Evans blue dye extravasation, and expressions of tight junction proteins (Claudin-5, zonula occludens-1 [ZO-1]) were detected by immunofluorescent staining; expressions of neutrophil extracellular traps (NETs)-related proteins (citrullinated histone H3 [citH3], myeloperoxidase [MPO] and matrix metalloproteinase 9 [MMP-9]) were determined by Western blotting. (2) Bone marrow neutrophils were extracted from male C57BL/6 mice and randomly divided into a control group, a phorbol 12-myristate 13-acetate (PMA) group, and a PMA+BA group; neutrophils in the PMA group were stimulated with PMA (50 nmol/L), while neutrophils in the PMA+BA group were co-treated with 50 nmol/L PMA and 50 μmol/L BA; and those in the control group were given an equal amount of dimethyl sulfoxide. Sytox Green staining was used to detect the NETs proportion in neutrophils.Results:(1) Baseline cerebral perfusion was robust (1 237.75±98.16 PU), which was markedly reduced during occlusion (297.36±77.63 PU) in the ipsilateral middle cerebral artery territory, and improved following reperfusion (939.21±73.63 PU). Compared with the MCAO group, mice in the L-BA group and H-BA group had lower mNSS score, increased paw grip strength, prolonged rotarod retention time, reduced infarct size, fewer neuronal death, lower brain tissue water content, reduced blood-brain barrier permeability, increased fluorescent intensities of Claudin-5 (0.51±0.11, 0.71±0.04, and 0.83±0.05) and ZO-1 (0.43±0.09, 0.65±0.05, and 0.81±0.03), and decreased protein expressions of citH3 (2.33±0.15, 1.92±0.03, and 1.42±0.04), MPO (2.14±0.08, 1.71±0.06, and 1.37±0.03) and MMP-9 (2.62±0.09, 1.83±0.06, and 1.41±0.05), with significant differences ( P<0.05). All the above changes in the H-BA group were more significant than those in the L-BA group ( P<0.05). (2) Compared with that in the control group (10.00%±8.00%), the proportion of NETs formation per field in both PMA group (85.33%±2.08%) and PMA+BA group (58.46%±5.29%) was significantly increased ( P<0.05); the PMA+BA group showed a significant reduction in NETs formation compared with the PMA group ( P<0.05). Conclusion:BA can alleviate cerebral edema in mice after cerebral ischemia-reperfusion, and its mechanism may be involved in inhibiting NETs formation.

Objective:To investigate the effect of nefazodone on excessive activation of microglia and its regulatory mechanism, as well as its effect on neurological injury in mice subjected to middle cerebral artery occlusion (MCAO).Methods:(1) BV2 cell line was routinely cultured in vitro, and primary microglia from the cortex of neonatal C57BL/6J mice were cultured. Cell counting kit-8 (CCK-8) assay was employed to assess the effects of nefazodone (0, 10, 20, 30, 50 μmol/L) on viability of BV2 cells and primary microglia to determine the working concentration. BV2 cells and primary microglia were divided into a normal control group, a lipopolysaccharide (LPS) group, and a nefazodone group; cells in the nefazodone group were pretreated with 20 μmol/L nefazodone for 2 h; cells in the LPS group and nefazodone group were stimulated with LPS (0.5 μg/mL for BV2 cells and 0.1 μg/mL for primary microglia) for 24 h; cells in the normal control group received an equivalent volume of solvent. Immunofluorescent staining was used to detect the expressions of ionized calcium-binding adapter molecule 1 (Iba1) and CD68. Reverse transcription quantitative PCR (RT-qPCR) was performed to measure interleukin ( IL) -1β, IL-6, tumor necrosis factor-α ( TNF-α), nitric oxide synthase 2 ( Nos2), C-C motif chemokine ligand 2 ( CCL2), and β-hexosaminidase subunit β ( Hexb) mRNA expressions. ELISA was used to quantify the concentrations of supernatant IL-1β, IL-6, and TNF-α in BV2 cells. Western blotting was applied to detect the protein expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in BV2 cells. Griess reagent assay was used to measure supernatant nitric oxide (NO) level in BV2 cells. Western blotting was also used to assess the protein expressions of extracellular signal-regulated kinase (ERK), phosphorylated (p)-ERK, c-Jun N-terminal kinase (JNK), p-JNK, p38, p-p38, nuclear factor kappa B p65 and p-p65 in BV2 cells. (2) Thirty male C57BL/6J mice were randomly divided into a normal control group, a MCAO group, and a nefazodone group, with 10 mice in each group. MCAO model in the MCAO group and nefazodone group was established using suture method; the nefazodone group received an intraperitoneal injection of nefazodone (15 mg/kg) 30 min after modeling, while the normal control group received an equivalent volume of solvent. Three days after modeling, neurological deficits were evaluated using modified neurological severity score (mNSS), and behavioral changes were evaluated by paw grip strength test and foot-fault test. Cerebral infarction volume was assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Iba1 protein expression in the ischemic penumbra was detected by Western blotting. Results:(1) CCK-8 assay showed no significant difference in viability of BV2 cells between the normal control group and 10 or 20 μmol/L nefazodone groups ( P>0.05), and viability of BV2 cells in 30 and 50 μmol/L nefazodone groups was statistically lower than that of normal control group ( P<0.05). Immunofluorescent staining revealed that compared with the normal control group, the LPS group had significantly increased fluorescent intensities of CD68 and Iba1; compared with the LPS group, the nefazodone group had significantly decreased fluorescent intensities of CD68 and Iba1 ( P<0.05). RT-qPCR results indicated that compared with those in the normal control group, the Nos2, CCL2, IL-1β, IL-6, and TNF-α mRNA expressions in both BV2 cells and primary microglia of the LPS group were significantly increased; compared with the LPS group, the nefazodone group had significantly decreased CCL2, IL-1β, and IL-6 mRNA expressions in BV2 cells, and significantly decreased Nos2, CCL2, IL-1β, IL-6, and TNF-α mRNA expressions in primary microglia ( P<0.05). ELISA showed that compared with those in the normal control group, the supernatant IL-1β, IL-6, and TNF-α levels significantly increased in the BV2 cells of LPS group; compared with those in the LPS group, supernatant IL-1β, IL-6 and TNF-α levels statistically decreased in the nefazodone group ( P< 0.05). Western blotting demonstrated that compared with those in the normal control group, the iNOS and COX-2 protein expressions significantly increased in BV2 cells of the LPS group ( P<0.05); compared with those in the LPS group, the iNOS and COX-2 protein expressions in BV2 cells of the nefazodone group statistically decreased ( P<0.05). Griess assay showed that compared with the normal control group, BV2 cells in the LPS group had significantly increased supernatant NO concentration ( P <0.05); compared with the LPS group, BV2 cells in the nefazodone group had significantly decreased supernatant NO concentration ( P<0.05). Western blotting revealed that compared with those in the normal control group, the p-ERK/ERK and p-JNK/JNK ratios significantly increased in BV2 cells of the LPS group ( P<0.05); compared with the LPS group, the p-p65/p65, p-ERK/ERK and p-JNK/JNK ratios significantly decreased in BV2 cells of the nefazodone group ( P<0.05). (2) Behavioral tests showed that compared with the normal control group, the MCAO group had significantly decreased forelimb grip strength and increased foot-fault rate ( P<0.05); compared with the MCAO group, the nefazodone group had significantly decreased mNSS score, increased forelimb grip strength and decreased foot-fault rate ( P<0.05). The percentage of cerebral infarction volume in the nefazodone group was significantly lower than that in the MCAO group ([9.56±1.81]% vs. [21.71±12.26]%, P< 0.05). The MCAO group had statistically higher Iba1 protein expression in ischemic penumbra (7.27±2.88) than the normal control group (1.00±0.64), and the nefazodone group had significantly lower Iba1 protein expression in ischemic penumbra (1.75±0.86) than the MCAO group ( P<0.05). Conclusion:Nefazodone can improve neurological function impairment in MCAO mice by inhibiting the excessive activation of microglia; cytological experiments suggest that its mechanism may be related to the negative regulation of ERK/JNK/NF-κB p65 signaling axis.

Ischemic stroke caused by intracranial vascular occlusion has become increasingly prevalent with considerable mortality and disability, which gravely burdens the global economy. Current relatively effective clinical treatments are limited to intravenous alteplase and thrombectomy. Even so, patients still benefit little due to the short therapeutic window and the risk of ischemia/reperfusion injury. It is therefore urgent to figure out the neuronal death mechanisms following ischemic stroke in order to develop new neuroprotective strategies. Regarding the pathogenesis, multiple pathological events trigger the activation of cell death pathways. Particular attention should be devoted to excitotoxicity, oxidative stress, and inflammatory responses. Thus, in this article, we first review the principal mechanisms underlying neuronal death mediated by these significant events, such as intrinsic and extrinsic apoptosis, ferroptosis, parthanatos, pyroptosis, necroptosis, and autophagic cell death. Then, we further discuss the possibility of interventions targeting these pathological events and summarize the present pharmacological achievements.
Brain Ischemia/pathology* ; Cell Death ; Humans ; Ischemic Stroke ; Reperfusion Injury/pathology* ; Stroke/pathology* ; Tissue Plasminogen Activator/therapeutic use*

Objective:To investigate the workflow, efficacy and safety of MR-Linac in liver malignancies.Methods:Clinical data of 15 patients with hepatocellular carcinomas (HCC) or liver metastases treated with MR-Linac between November 2019 and July 2021 were retrospectively analyzed. The workflow of MR-Linac was investigated and image identification rate was analyzed. Patients were followed up for response and toxicity assessment.Results:Fifteen patients (6 HCC, 8 liver metastases from colorectal cancer, 1 liver metastasis from breast cancer) were enrolled. A total of 21 lesions were treated, consisting of 10 patients with single lesion, 4 patients with double lesions and 1 patient with triple lesions. The median tumor size was 2.4 cm (0.8-9.8 cm). The identification rate for gross tumor volume (GTV) in MR-Linac was 13/15. Although GTV of two patients were unclearly displayed in MR-Linac images, the presence of adjacent blood vessel and bile duct assisted the precise registration. All the patients were treated with stereotactic body radiation therapy (SBRT). For HCC, the median fraction dose for GTV or planning gross tumor volume (PGTV) was 6 Gy (5-10 Gy) and the median number of fractions was 9(5-10). The median total dose was 52 Gy (50-54 Gy) and the median equivalent dose in 2 Gy fraction (EQD 2Gy) at α/ β= 10 was 72 Gy (62.5-83.3 Gy). For liver metastases, the median fraction dose for GTV or PGTV was 5 Gy (5-10 Gy) and the median number of fractions was 10(5-10). The median total dose was 50 Gy (40-50 Gy) and the median EQD 2Gy at α/ β=5 was 71.4 Gy (71.4-107.1 Gy). At 1 month after SBRT, the in-field objective response rate (ORR) was 8/13 and the disease control rate was 13/13. At 3-6 months after SBRT, the in-filed ORR was increased to 6/6. During the median follow-up of 4.0 months (0.3-11.6), 4-month local progression-free survival, progression-free survival and overall survival were 15/15, 11/15 and 15/15, respectively. Toxicities were mild and no grade 3 or higher toxicities were observed. Conclusions:MR-Linac provides a platform with high identification rates of liver lesions. Besides, the presence of adjacent blood vessel and bile duct also assists the precise registration. It is especially suitable for liver malignancies with promising local control and well tolerance.