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 expressions of NLRP1 and NLRP3 in the colon of ulcerative colitis (UC) patients and analyze the correlation of the expressions with severity of UC, endoscopic manifestations and related laboratory indicators. 【Methods】 We collected biopsical specimens obtained with colonoscopy in 46 patients with UC (22 mild cases and 24 moderate to severe cases) and 20 cases of normal control group. We used the disease activity index to evaluate the Mayo UC inflammatory activity and immunohistochemical method to detect the protein expression levels of intestinal mucosal NLRP1 and NLRP3 in the tissue. RT-PCR was used to detect the expressions of NLRP1 and NLRP3 mRNA in intestinal mucosal tissues. Meanwhile, the colonoscopy, serum uric acid, C-reactive protein, serum sedimentation rate, platelet count, low-density lipoprotein, and cholesterol of UC patients were also counted to further analyze the relationship between NLRP1 and NLRP3. 【Results】 The expressions of NLRP1 and NLRP3 protein and mRNA in colonic mucosal tissues of UC patients were significantly higher than those of normal controls (P<0.05). Compared with that in mild UC, the expression of NLRP1 in colonic mucosal tissues of moderate and severe UC patients was significantly increased (P<0.05). There was no significant difference in the expressions of NLRP1 and NLRP3 in colonic mucosal tissues of UC patients with different lesion ranges. NLRP1 expression was positively correlated with Mayo overall score, Mayo endoscopic score, erythrocyte sedimentation rate, and C-reactive protein (P<0.05), NLRP3 expression was positively correlated with C-reactive protein (P<0.05), but not correlated with Mayo overall score, Mayo endoscopic score, or erythrocyte sedimentation rate. NLRP1 expression was positively correlated with low-density lipoprotein and platelet (P<0.05), but not with uric acid or cholesterol. NLRP3 was positively correlated with low-density lipoprotein, uric acid and cholesterol (P<0.05), but not with platelet. 【Conclusion】 NLRP1 and NLRP3 may be involved in the pathogenesis of UC and related to disease activity. Therefore, they can be used as molecular targets for targeted therapy, and NLRP1 can be used as a predictor of mucosal healing.

OBJECTIVE：To study the improvement effects of total ginsenosides on the senescence of PC 12 cells induced by D-galactose and its mechanism. METHODS ：Rat pheochromocytoma （PC12）cells were treated with D-galactose to establish cell senescence model. CCK- 8 method was used to screen the D-galactose modeling concentration and total ginsenosides concentration. Normal control group ，model group ，total ginsenosides low and high concentration groups were set up. Cell senescence ，cell apoptosis rate ，apoptotic cycle and mitochondrial membrane potential （MMP），cell adenosine triphosphate （ATP）and reactive oxygen species （ROS）levels in each group were detected. The expression of apoptosis related proteins [B lymphoma 2（Bcl-2）and its related egg X protein （Bax），cytochrome C （Cyt-C）] and oxidative damage related proteins [nuclear factor 2 related factor 2 （Nrf2），heme oxygenase 1（HO-1）] were detected. In addition ，positive drug group [ 5 mmol/L N-acetyl-L-cysteine（NAC）] and positive control group [ D-galactose+5 mmol/L NAC] were set up to compare the levels of oxidative damage related proteins. RESULTS：D-galactose could significantly inhibit the survival rate of PC 12 cells，with a critical concentration of 20 mg/mL. The total ginsenosides could significantly increase the survival rate of D-galactose induced senescent cells with a median effective concentration（EC50）of 65 μg/mL，and then the low and high concentrations of total ginsenosides were set at 55 and 65 μg/mL. Compared with normal control group ，the number of aging cells increased ，the apoptotic rate and percentage of G 1 phase were significantly increased i n model group. the percentage of S phase ，MMP and ATP contents ，the protein expression of Bcl- 2 and Cyt-C in mitochondria were decreased significantly ，whileROS content ，the protein expression of Bax ，Nrf2 and Cyt-C protein in endochylema were increased significantly （P＜0.05 or P＜0.01）. Compared with model group ，the number of E-mail：sunqiao150509@163.com aging cells reduced ，the apoptosis rates and percentage of G 1 phase were significantly decreased in total ginsenosides low and high concentration groups ，the percentage of S phase ，the contents of MMP and ATP （except for low concentration group ），protein expression of Bcl- 2，Nrf2 and HO- 1 as well as protein expression of Cyt-C in mitochondria were increased significantly ；ROS level （except for low concentration group ）and Bax protein as well as protein expression of Cyt-C were decreased significantly. The protein expression of Nrf 2 and HO- 1 were increased significantly in positive control group （P＜0.05 or P＜0.01）， but it was lower than that of total ginsenosides groups . CONCLUSIONS：Total ginsenosides can improve D-galactose induced senescence of P 12 cells，the mechanism of which may be related to activating Nrf 2 antioxidant signal pathway to antagonize D-galactose induced oxidative stress and alleviating mitochondrial dysfunction.

Objective To investigate the value of three dimensional time-of-flight (3D-TO)F) and three dimensional fast imaging employing steady state acquisition (3D-FIESTA)sequences in evaluation on spatial relationship among trigeminal nerve,facial nerve and peripheral vessels before microvascular decompression(MVD)with 3.0 T MR.Methods Data of MRI of 36 patients with trigeminal neuralgia (TN) and 31 with hemifacial spasm (HFS) before MVD were analyzed retrospectively.The intra-observer agreement for the spatial relationship among trigeminal nerve,facial nerve and adjacent blood vessels were observed.The differences of occurrence rates of neurovascular compression (NVC) of symptomatic side and asymptomatic side in TN and HFS patients were compared.Taking surgical results as the gold standards,the diagnostic efficacy for neurovascular relationships of symptomatic side with 3D-TOF and 3D-FIESTA sequences were calculated.Results The consistency between two observers in assessing relationship of trigeminal nerve,facial nerve and adjacent blood vessels of symptomatic and asymptomatic was good (all Kappa≥0.75,all P＜0.001).In both of TN and HFS patients,the occurrence rates of NVC of symptomatic side were significantly higher than those of asymptomatic side (x2=26.13,20.81,both P＜ 0.001).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of 3D-TOF and 3D-FIESTA sequences in displaying relationship of trigeminal nerve and vascular was 97.22％ (35/36),97.06％ (33/34),100％ (2/2),100％ (33/33)and 66.67％ (2/3),respectively,of relationship between facial nerve and vascular was 93.55％ (29/31),96.55％ (28/29),50.00％ (1/2),96.55％ (28/29) and 50.00％ (1/2),respectively.Conclusion 3D-TOF and 3D-FIESTA sequences can clearly display the spatial relationship of nerve and adjacent vessels,therefore providing imaging evidences for MVD.

Background:TIPE2 is a newly identified negative regulator of innate and adaptive immunity that maintains immune homeostasis and immune tolerance. It has been demonstrated that TIPE2 is expressed in a wide variety of tissues and organs in humans. Aims:To investigate the expression of TIPE2 in peripheral blood and colonic mucosa of patients with ulcerative colitis(UC)and non-UC subjects,and to explore the role of TIPE2 in the initiation and development of UC. Methods:Forty-two peripheral blood samples and 30 colonic mucosa samples from patients with active UC were collected during Jan. 2015 to Aug. 2016 at the Second Affiliated Hospital of Xian Jiaotong University. Peripheral blood and colonic mucosa samples from non-UC subjects were served as controls. Real-time PCR and immunohistochemical staining were used to detect the mRNA and protein expressions of TIPE2 in peripheral blood mononuclear cells and colonic mucosal tissues, respectively. Results:Expression level of TIPE2 mRNA in peripheral blood of UC patients had a trend to increase but no significant difference was found between UC patients and the controls(P >0.05). When classified by Truelove-Witts severity index,there was no significant difference among patients with severe,moderate and mild UC(P >0. 05). Expression level of TIPE2 protein was significantly higher in colonic mucosa of UC patients than that of the controls(P<0.05);the expression level increased with increase of histological grade of UC,but the difference was not statistically significant(P > 0.05). Conclusions:Increased colonic expression of TIPE2 might contribute to the initiation and development of UC.

Objective To investigate the value of MR diffusion tensor imaging(DTI)in assessment of the microstructural changes of the trigeminal nerve,and analyze it's correlation with the degree of vascular compression. Methods Thirty-four patients with trigeminal neuralgia from November 2015 to April 2017 were retrospectively analyzed in this study.And they were treated by microvascular decompression(MVD). There were 11 cases of gradeⅠ,16 cases of gradeⅡand 7 cases of gradeⅢaccording to the severity of the contact between nerves and vessels during the operation. All of them were scanned with three dimensional time-of-flight(3D-TOF)sequences, three dimensional fast imaging employing steady state acquisition(3D-FIESTA)sequences and DTI before undergoing surgical decompression. According to the preoperative MR scans,the trigeminal nerves were divided into the healthy side without neurovascular contact (25 cases) and the healthy side with a neurovascular contact (9 cases).The DTI parameters of the trigeminal nerve,including the anisotropic fraction(FA)and the ADC values were obtained.Comparison of the FA and ADC values of the trigeminal nerve between the different stages of the affected side was performed with single factor analysis of variance, and the paired samples t test was used to compare the difference of FA and ADC values of bilateral trigeminal nerve. The difference of FA and ADC values between the asymptomatic side with or without vascular contact was compared with independent sample t test. Spearman correlation analysis was used to evaluate the correlation between DTI parameters and the degree of compression. Results The FA values of patients with grades Ⅰ,ⅡandⅢwere 0.311±0.009, 0.308±0.007 and 0.299±0.009 respectively,and there was significant difference among different levels(F=5.269,P<0.05).The ADC values of the three grades were(2.298 ± 0.309)×10-3,(2.214 ± 0.175)×10-3and (2.259 ± 0.248)×10-3mm2/s respectively, showing no statistically significant difference(F=0.402,P>0.05). The FA values of bilateral trigeminal nerves in healthy side without neurovascular contact and in healthy side with neurovascular contact were statistically significant (t=-32.528,-25.178,P<0.05). There was significant difference in the ADC value of bilateral trigeminal nerves in the group without neurovascular contact(t=2.162,P<0.05).There was no statistically significant difference in the ADC values of bilateral trigeminal nerves in the healthy side of the neurovascular contact group(P>0.05).There were no statistically significant differences in the FA and ADC values between the two groups on the healthy side of the trigeminal nerve(P>0.05).The FA value was negatively correlated with the degree of vascular compression (r=-0.453,P<0.05),while the ADC value was not correlated with the degree of vascular compression(P>0.05). Conclusion DTI imaging can be used to evaluate the degree of trigeminal nerve injury. More obvious vascular compression leads to lower FA value.

Objective To compare the intubating conditions between dexmedetomidine and remifentanil when combined with sevoflurane-nitrous oxide (N2O) for anesthesia induction in the pediatric patients.Methods A total of 122 pediatric patients,aged 4-10 yr,of American Society of Anesthesiologists physical status Ⅰ,undergoing elective plastic surgery,were randomly divided into dexmedetomidine group (group D,n =61) and remifentanil group (group R,n=61).Eight percent sevoflurane and 60％ N2O were inhaled for induction of anesthesia,and the fresh gas flow was set at 6 L/min.After disappearance of eyelash reflex,dexmedetomidine 1 μg/kg and remifentanil 1 μg/kg were intravenously injected over 50-60 s in D and R groups,respectively,and 1 min later tracheal intubation was performed.The intubating conditions were graded,and the satisfactory intubating conditions and successful intubation were recorded.The development of adverse cardiovascular reactions and complications such as hyoxemia and laryngospasm before and after intubation and postoperative pharyngodynia was recorded.Results Compared with group D,no significant change was found in the success rate of intubation,rate of satisfactory intubation,intubating condition grade or incidence of postoperative pharyngodynia (P＞ 0.05),and the incidence of hypertension and sinus tachycardia after intubation was significantly increased in group R (P＜0.05).No pediatric patients developed hyoxemia,laryngospasn or sinus tachycardia in two groups.Conclusion When 8％ sevoflurane and 60％ N2O are inhaled for anesthesia induction,combing with dexmedetomidine 1 μg/kg produces better clinical efficacy than combing with remifentanil 1 μg/kg in improving the intubating conditions for pediatric patients.

Objective To evaluate and compare the efficacy and safety of sedative and analgesic anesthesia in surgical patients with supine and prone position .Methods Sixty female patients, American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged from 18 -53 years, scheduled for elective plastic operations under sedative and analgesic anesthesia combined with local anesthesia were divided into two groups according to their surgical positions: supine group ( n=30 ) and prone group ( n=30 ) .All patients received Ⅳ dexmedetomidine ( DEX) 1 μg/kg over 15 min followed by 0.4 -0.7 μg/kg/h infusion. Both groups were administered Ⅳ midazolam 0.04 mg/kg and a continuous infusion of remifentanil of 0.1 μg/kg/min at the beginning of anesthesia .Heart rate ( HR) , mean arterial pressure (MAP), pulse oximetry (SpO2), respiratory rate (RR), bispectral index (BIS) and Ramsay sedation scores ( RSS) were recorded at the following time points: before anesthesia ( T0 ) , 5 min after induction with midazolam ( T1 ) , 10 min after induction of midazolam ( T2 ) , immediately after induction with DEX( T3 ) , the beginning of local anesthesia ( T4 ) , the beginning of surgery ( T5 ) , 30 min after anesthesia induction ( T6 ) , 60 min after anesthesia induction ( T7 ) , immediately after turning off DEX infusion (T8), the end of surgery (T9).Incidences of respiratory depression, incidences of apnea, oxygen supplementation by facial mask and jaw-thrust, frequencies of body movements and additional rescue medication were also recorded .After surgery , recall of events during surgery , the visual analogue scales (VAS) for pain in PACU, the satisfaction levels of patients and surgeons were also assessed .Results No significant differences were found in MAP , SpO2 , RR, BIS, RSS scores at any time point between two groups (all P >0.05).There were no significant differences in incidences of respiratory depression , frequencies of body movements and additional rescue medication during surgery between groups ( all P>0. 05).Neither were recall of events during surgery , the visual analogue scales (VAS) for pain and the satisfaction levels of patients and surgeons after surgery (all P>0.05).The HR at time points of T0, T1, T2 in prone group were significantly higher than those in supine group (all P<0.05).Compared with the supine group , the incidences of apnea , oxygen supplementation by facial mask and jaw-thrust in prone group were significantly lower .Conclusions Sedative and analgesic anesthesia is effective and safe for patients with prone surgical position and has a lower incidence of upper airway obstruction during surgery than patients in supine surgical position .

Objective To evaluate and compare the efficacy and safety of sedative and analgesic anesthesia in surgical patients with supine and prone position .Methods Sixty female patients, American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged from 18 -53 years, scheduled for elective plastic operations under sedative and analgesic anesthesia combined with local anesthesia were divided into two groups according to their surgical positions: supine group ( n=30 ) and prone group ( n=30 ) .All patients received Ⅳ dexmedetomidine ( DEX) 1 μg/kg over 15 min followed by 0.4 -0.7 μg/kg/h infusion. Both groups were administered Ⅳ midazolam 0.04 mg/kg and a continuous infusion of remifentanil of 0.1 μg/kg/min at the beginning of anesthesia .Heart rate ( HR) , mean arterial pressure (MAP), pulse oximetry (SpO2), respiratory rate (RR), bispectral index (BIS) and Ramsay sedation scores ( RSS) were recorded at the following time points: before anesthesia ( T0 ) , 5 min after induction with midazolam ( T1 ) , 10 min after induction of midazolam ( T2 ) , immediately after induction with DEX( T3 ) , the beginning of local anesthesia ( T4 ) , the beginning of surgery ( T5 ) , 30 min after anesthesia induction ( T6 ) , 60 min after anesthesia induction ( T7 ) , immediately after turning off DEX infusion (T8), the end of surgery (T9).Incidences of respiratory depression, incidences of apnea, oxygen supplementation by facial mask and jaw-thrust, frequencies of body movements and additional rescue medication were also recorded .After surgery , recall of events during surgery , the visual analogue scales (VAS) for pain in PACU, the satisfaction levels of patients and surgeons were also assessed .Results No significant differences were found in MAP , SpO2 , RR, BIS, RSS scores at any time point between two groups (all P >0.05).There were no significant differences in incidences of respiratory depression , frequencies of body movements and additional rescue medication during surgery between groups ( all P>0. 05).Neither were recall of events during surgery , the visual analogue scales (VAS) for pain and the satisfaction levels of patients and surgeons after surgery (all P>0.05).The HR at time points of T0, T1, T2 in prone group were significantly higher than those in supine group (all P<0.05).Compared with the supine group , the incidences of apnea , oxygen supplementation by facial mask and jaw-thrust in prone group were significantly lower .Conclusions Sedative and analgesic anesthesia is effective and safe for patients with prone surgical position and has a lower incidence of upper airway obstruction during surgery than patients in supine surgical position .

Objective To study the clinical characteristics of triple-negative breast neoplasms patients, and analyze the factors affecting its prognosis. Methods Use medical record survey method,collect the hospital from September 2011 to October 2013 of 66 cases of three negative breast cancer,it can be divided into triple-negative breast (TNBC groups,16 cases)and the non-triple-negative breast group (non-TNBC group,50 cases). Withχ2 test and Fisher exact probability for the survival of patients situation and clinical pathology characteristic clinical data as well as to the age,tumor size,axillary lymph node number, pathological type,factors such as local and distant metastasis for statistical analysis. Results The triple-negative breast cancer group and the non-triple-negative breast cancer in clinical pathol-ogy characteristics,menstrual status differences had no statistical significance(P>0.05);pathologic examination,tumor size,axillary lymph node number,pathological type,such as local and distant metastasis showed in the two groups was statistically difference (P<0.05); the recurrence metastasis rate of two groups had a differences with statistically sig-nificant (P<0.05). Conclusion The triple-negative was a high risk of breast cancer, breast cancer in premenopausal women. The association between tumor size and axillary lymph node status was not big; tumor diameter of the head,high recurrence rate, distant metastasis occurred early; should promote targeted drugs appeared for triple-negative breast cancer patients.