Liver cancer is one of the most common cancers in China. In recent years, liver cancer tends to be treated with comprehensive therapies, including surgery, ablation, interventional embolization, radiotherapy, chemotherapy, targeted therapy, immunotherapy, and liver transplantation. At present, the low surgical resectionrate is one of the main factors affecting the prognosis of liver cancer patients. Preoperative neoadjuvant therapy or conversion therapy for liver cancer can maximize the rate of surgical resection and improve the prognosis. With the rapid development of radiotherapy and immunotherapy in the comprehensive treatment of liver cancer, it has been gradually confirmed that the unique effects of preoperative radiotherapy and immune therapy for liver cancer can improve the prognosis of the patients. Therefore, this paper reviewed the research progress in the preoperative radiotherapy and immunotherapy for liver cancer by searching relevant literature and reports at home and abroad.

Objective To investigate the correlation between carotid intima-media thickness (CIMT) and left atrial and left ventricular enlargement in patients with acute cerebral infarction. Methods A total of 224 patients with acute cerebral infarction were included. Based on the thickness of CIMT, it was divided into three groups which were normal CIMT group, thickening CIMT group, and carotid plaque (CP) group, with 57, 97, and 70 patients included respectively. Clinical data were collected, and carotid artery color Doppler ultrasound, cardiac color Doppler ultrasound and other examinations were determined to carry out relevant statistical analysis.Results The left anterior-posterior diameter (LAD) , left atrial diameter index (LADI) , left ventricular end-diastolic septal thickness (IVSD) , and left ventricular mass index (LVMI) in the CP group were all higher than those in the normal CIMT group and thickening CIMT group (P < 0.05). The percentage of the left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) took in the thickening CIMT group were both higher than those in the CP group (P < 0.05). Multi-factor logistic regression analysis indicated that there were statistically significant differences in age, homocysteine and left LVMI (P < 0.05). In the Pearson correlation analysis, CIMT and LADI were positively correlated (r= 0.184, P < 0.01) , and there was a positive correlation between CIMT and LVMI (r = 0.236, P < 0.01). Conclusions Left ventricular enlargement is one of the highrisk factors for CIMT abnormalities in patients with acute cerebral infarction. Left atrial and left ventricular enlargement are closely correlated to the severity of CIMT in patients with acute cerebral infarction, indicating that abnormal CIMT in patients with acute cerebral infarction has a certain predictive effect on left atrial and left ventricular enlargement.

PURPOSE: Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI)was evaluated regarding its ability to preliminarily predict the short-term treatment response of nasopharyngeal carcinoma (NPC) following intensity-modulated radiation therapy. MATERIALS AND METHODS: IVIM-DWI with 14 b-factors (0-1,000 sec/mm2) was performed with a 3T MR system on 47 consecutive NPCs before, during (end of the 5th, 10th, 15th, 20th, and 25th fractions), and after fractional radiotherapy. IVIM parametrics (D, f, and D*) were calculated and compared to the baseline and xth fraction. Patients were categorized into responders and non-responders after radiotherapy. IVIM parametrics were also compared between subgroups. RESULTS: After fractional radiations, the D (except D5 and D at the end of the 5th fraction) after radiations were larger than the baseline D0 (p < 0.05), and the post-radiation D* (except D*5 and D*10) were smaller than D*0 (p < 0.05). f0 was smaller than f5 and f10 (p < 0.001) but larger than fend (p < 0.05). Furthermore, greater D5, D10, D15, and f10 coupled with smaller f0, D*20, and D*25 were observed in responders than non-responders (all p < 0.01). Responders also presented larger ΔD10, Δf10, ΔD*20, and δD*20 than non-responders (p < 0.05). Receiver operating characteristic curve analysis indicated that the D5, D*20, and f10 could better differentiate responders from non-responders. CONCLUSION: IVIM-DWI could efficiently assess tumor treatment response to fractional radiotherapy and predict the radio-sensitivity for NPCs.
Diffusion* ; Humans ; Radiation Tolerance ; Radiotherapy ; Radiotherapy, Intensity-Modulated ; ROC Curve

Objective: To investigate the clinical value of plasma EBV DNA in monitoring clinical efficacy in the treatment of nasopharyngeal carcinoma (NPC). Methods: Clinical data of 799 patients initially diagnosed with NPC treated with radical intensity-modulated radiotherapy (IMRT) in our hospital from 2016 to 2017 were analyzed retrospectively. Prior to treatment, the correlation between plasma EBV DNA, clinical stage and tumor progression was analyzed. The relationship between EBV DNA and tumor progression was analyzed after radiotherapy and during follow-up. Results: Before IMRT, the level of EBV DNA was positively correlated with both clinical stage and tumor progression (both P<0.001). At 6 to 8 weeks after IMRT, 19(2.3%) patients positive for plasma EBV DNA obtained the worst prognosis and 14 cases had tumor progression. At 6-8 weeks after IMRT, 9 patients were negative for EBV DNA and 3 cases had tumor progression. The tumor progression rate of patients with undetectable plasma EBV DNA at the end of IMRT was only 8.3%(64/772), and the progression-free survival rate significantly differed among three groups (all P<0.05). The sensitivity, specificity and accuracy rates of persistent positive plasma EBV DNA during follow-up were calculated as 77.6%, 100% and 98.1%, respectively. Conclusions The level of plasma EBV DNA in patients with NPC is correlated with tumor bearing and tumor progression prior to IMRT. At 6-8 weeks after IMRT, patients who are persistently positive for EBV DNA obtain the worst prognosis and should be given with appropriate adjuvant therapy. The correlation between persistent positive plasma EBV DNA during follow up and tumor progression yields a high accuracy rate, indicating that plasma EBV DNA is a reliable biomarker for monitoring the clinical efficacy after radical treatment for NPC patients.

Objective To evaluate and compare the analytical performances and application values of three nucleic acid extraction methods for quantification of plasma Epstein-Barr Virus ( EBV ) DNA. Methods It used silica membrane spin column , boiling and automated magnetic bead method to extract viral nucleic acid in parallel , and combined real-time fluorescence quantitative PCR assays for quantitative EBV-DNA quantification.The performances of three methods were determined and compared by using the third-party reference materials , and the clinical values were analyzed by pairing detecting 100 NPC patients and 100 healthy subjects in pair .Results The accuracy and imprecision of three methods were all in line with requirements , and the results of clinical samples were linearly correlated . But actually the reproducibility and intermediate imprecision of the magnetic bead method were smaller and stable than those of the spin column method and the boiling method ( all <3％);the limit of detection for the magnetic bead method was 3.334 ×101 IU/ml, better than that of spin column method (4.159 ×101 IU/ml) and boiling method (8.511 ×101 IU/ml);the linear range of the magnetic bead method was 5.4 ×101 -5.4 ×105 IU/ml, slightly wider than that of the boiling method (5.4 ×102 -5.4 ×105 IU/ml); the ability of anti -Hb interference ability of magnetic bead method is better than that of boiling method ;and the positive rate and the mean viral load of the NPC samples measured with the magnetic bead method were significantly higher (95％, 8.342 ×103 IU/ml) than those measured with the spin column method (84％, 4.707 ×103 IU/ml) and the boiling method (78％, 2.571 ×103 IU/ml) ( P all<0.05).Conclusion The automated magnetic bead nucleic acid extraction method offered better analytical performance and higher clinical value for EBV DNA quantification in plasma .

Objective     To explore the effect of 16F gastric tube on pain relief in postoperative lung cancer patients. Methods     A total of 118 lung cancer patients were treated with radical resection of lung cancer in our hospital between January 2015 and May 2016. The patients were assigned into two groups: a 16F gastric tube group (16F group, 60 patients, 30 males and 30 females at age of 41-73 (52.13±7.83) years and a 28F drainage tube group (28F group, 58 patients, 25 males and 33 females at age of 45-75 (55.62±4.27) years. Clinical effects were compared between the two groups. Results     There was no statistical difference in drainage time (4.47±1.03 d vs. 4.24±1.16 d, P=0.473), drainage amount (560.37±125.00 ml vs. 656.03±132.45 ml, P=0.478), incidences of pneumothorax (5/60 vs. 2/58, P=0.439), pleural effusion (6/60 vs. 3/58, P=0.522), and subcutaneous emphysema (3/60 vs. 1/58, P=0.635) between the two groups (P>0.05). The pain caused by the drainage tube in the16F group was less than that in the 28F drainage tube group with a statistical difference (F=4 242.996, P<0.001). The frequency of taking analgesics in the 16F group was significantly less than that in the 28F group (12/60 vs. 26/58, P<0.001). Conclusion     The effects of draining pleural effusions and promoting lung recruitment are similar between the 16F group and the 28F group. However, the wound pain caused by 16F gastric tube is significantly less than that by 28F drainage tube.

Objective To analyze the prognosis of advanced esophageal carcinoma treated with paclitaxel and different platinum?based chemotherapy regimens plus intensity?modulated radiotherapy ( IMRT) , and to explore an optimal chemotherapy regimen. Methods A total of 242 patients with advanced esophageal carcinoma who were admitted to our hospital and treated with paclitaxel and cisplatin ( 68 patients), nedaplatin (85 patients), lobaplatin (58 patients), or oxaliplatin (31 patients) plus IMRT from 2008 to 2014 were enrolled as subjects. The prognosis of the four groups was analyzed after 2, 3, and ≥4 cycles of chemotherapy. The survival rates were calculated by the Kaplan?Meier method and analyzed by the log?rank test. The Cox model was used for the multivariate prognostic analysis. Results The sample number of 3 years was 168 cases. In all the 242 patients, the medium survival time was 31. 1 months and the 3?year overall survival ( OS) rate was 47. 4%. There was no significant difference in the 3?year OS rate between the cispaltin, nedaplatin, lobaplatin, and oxaliplatin groups ( 46. 2% vs. 56. 4% vs. 45. 7% vs. 29. 0%, P=0. 090) . The stratified analysis showed that the cisplatin, nedaplatin, and lobaplatin groups had a significantly higher OS rate than the oxaliplatin group ( 50. 1% vs. 29. 0%, P=0. 021 ) . There was no significant difference in the 3?year OS rate between patients receiving 2, 3, and≥4 cycles of chemotherapy ( 40. 1% vs. 49. 5% vs. 50. 8%, P=0. 264) . The multivariate analysis showed that esophageal tumor volume and the maximal size of metastatic lymph node were independent prognostic factors. Conclusions Combined with IMRT, paclitaxel plus cisplatin, nedaplatin, or lobaplatin?based chemotherapy achieves improved survival rates than paclitaxel plus oxaliplatin?based chemotherapy. Esophageal tumor volume and the maximal size of metastatic lymph node are independent prognostic factors.

Objective To compare the dosimetric difference among plans designed by 4-field,6-field TomoDirect and TomoHelical techniques in Tomotherapy system for left-breast cancer patients with radiotherapy after breast-conserving surgery.Method A total of 16 patients with left-breast cancer following breast-conserving surgery and intensity-modulated radiation therapy were enrolled in this retrospective study.The 4-field TomoDirect (TD4),6-field TomoDirect (TD6),and TomoHelical (TH) techniques were applied to design simulation plans in tomotherapy system for each patient,respectively.The differences of dose distribution and treatment parameters were analyzed in this study.Results Three plans all met the clinical requirement.Thereinto,TD4 was superior to TH in the dose limitation of organs at risk (OARs),especially the max dose of cord and right-breast,thc 5 Gy radiation volume of lung,and the mean dose of heart(F =595.60,129.24,60.44,65.37,P ＜ 0.05),but inferior to TH in dose homogeneity (HI) and conformity (CI) (F =2.78,60.93,P ＜ 0.05).However,TD6 improved TD4's HI and CI when delivered the lower OARs dose compared to TH.Meanwhile,the number of monitor units was less in TD technique and reduced the treatment times (F =24.89,3.75,P ＜ O.05).Conclusions For the radiotherapy of left-breast cancer patients after breast-conserving surgery,TD6 technique appeared to be superior,with the lower radiation dose of OARs compared to TH technique,and the better target's HI and CI in comparison with TD4 technique,especially in patients with early stage breast cancer.

Objective To investigate the association of Tim-1 protein expression and its gene polymorphism with nutritional parameters in patients with systemic lupus erythematosus (SLE).Methods Peripheral blood samples were collected from 126 patients with SLE.Serum Tim-1 protein levels were detected by ELISA,and the Tim-1 gene-416G＞C,-1454G＞A polymorphism was detected by PCR-RFLP.Prealbumin,ceruloplasmin,and retinol conjugated protein levels were determined by immunoturbidimetry.Ferritin and 1,25-dihydroxy vitamin D3 levels were detected by electrochemiluminescence.Results Concentrations of serum Tim-1 protein,prealbumin,ceruloplasmin,retinol binding protein,ferritin,and 1,25-dihydroxy vitamin D3 were 249.7±30.2 pg/mL,226±42 μg/mL,363±95 μg/mL,29.4± 13.2 μg/mL,355± 164 ng/mL,and 26.4-± 11.5 ng/mL,respectively.In the-416G＞C site,GG,GC,and CC genotypes accounted for 11.9％,57.1％,and 31.0％,respectively.In the-1454G＞A site,GG,GA,and AA genotypes accounted for 67.5％,26.2％,and 6.3％,respectively.The Tim-1 protein concentration did not differ significantly between the different genotypes of the-416G＞C site (F=0.575,P=0.564) or-1454G＞A site (F=1.255,P=0.289).Tim-1 level was significandy negatively correlated with prealbumin (r =-0.176,P =0.033),and positively correlated with ceruloplasmin (r =0.205,P =0.014) and 1,25-dihydroxy vitamin D3 (r=0.166,P=0.042).The serum prealbumin level decreased significantly (P=0.027) in patients harboring the GG genotype in the-1454G＞A site,whereas the serum 1,25-dihydroxy vitamin D3 level decreased significandy (P =0.024) in patients with the AA genotype in the-1454G＞A site.Conclusion Serum Tim-1 protein level and the-1454G＞A polymorphism of Tim-1 gene are associated with the nutritional function of patients with SLE.

Objective To investigate the factors related to death of thoracic trauma emergency in children.Methods Total 528 children and infants aged 0-14 years with thoracic injuries , including 317 boys and 211 girls, admitted in emergency department from January 2010 to January 2014 were included in the study.The factors related to emergency death were investigated by using conditional logistic analysis.Results Among 528 cases, emergency death occurred in 34 cases with an emergency mortality rate of 6.44%.Single-factor analysis showed that emergency death was correlated with complication with other organ trauma, the time of first medical intervention , the time of arriving at first contact hospital , the rank of first contact hospital , hypoxemia and causes of injuries ( all P<0.05 ); however , not correlated with the gender, age, of patients, areas of residence, family economic status and seasons of injury occurring (all P>0.05).Logistic analysis showed that the time of first medical interventio n>30 min ( B=1.467,95%CI:0.412-0.975), complication with other organ trauma (B=2.342,95%CI:0.415-0.943), hypoxemia (B=2.915,95%CI:0.749-0.819), and first visiting to tertiary hospital (B=-1.861,95%CI:1.023-1.742) were influencing factors of emergency death.Conclusion The results indicate that to improve the success rate of emergency treatment of thoracic trauma in children , it is necessary to reduce the time of first medical intervention and to correct the hypoxemia promptly.