Primary liver cancer(PLC)is one of the most common malignant diseases with the highest incidence and mortality rate,which poses a serious threat to public health in China.Thus,it is crucial to realize the early and accurate diagnosis of PLC.In clinical practice,traditional imaging techniques can provide the morphological information of liver cancer tissues,but they still have some limitations.Multimodality imaging can provide more comprehensive diagnostic information by integrating the advantages of different imaging technologies.By using liver cancer-specific targeting probes,multimodality imaging technology can achieve higher sensitivity and specificity than traditional imaging techniques.It can not only help with the accurate diagnosis of liver cancer by providing the structural and functional information of PLC simultaneously,but also guide surgeons to make better intraoperative decisions for PLC patients by supporting real-time navigation imaging during surgery.Therefore,multimodality imaging is of great significance to the clinical diagnosis and treatment of PLC.This review mainly focuses on the multimodality imaging technology and specific targeting probes of PLC,and summarizes the current research progress in this field.

Objective:To investigate the association of plasma epoxyeicosatrienoic acids (EETs) with early neurological deterioration (END), and whether EETs are mediated by EPHX2 gene variants in patients with minor ischemic stroke (MIS).Methods:This is a prospective, multi-center observational study in patients with acute MIS in the Chinese population. Acute MIS patients with the first onset and onset within 24 hours who were admitted to Deyang People′s Hospital, the Second Affiliated Hospital of Wenzhou Medical University and the Third Affiliated Hospital of Wenzhou Medical University from March 2013 to June 2015 were recruited. Plasma EETs levels were measured on admission. Single nucleotide polymorphisms of EPHX2 gene rs751141 were genotyped using mass spectrometry. The primary outcome was END within 10 days after admission. END was defined as an increase in National Institutes of Health Stroke Scale score of 2 or more points.Results:A total of 322 patients were enrolled, of which 85 (26.4%) patients experienced END. EETs levels were significantly lower in patients with END [(60.3±7.3) nmol/L] compared to patients without END [(68.4±8.1) nmol/L , t=8.464, P<0.001]. Frequency of EPHX2 gene rs751141 GG was higher in patients with END [66/85(77.6%)] than in patients without END [123/237(51.9%),χ2=17.130, P<0.001], and patients with EPHX2 gene rs751141 GG genotype showed lower EETs levels [GG: (59.6±7.8) nmol/L, AG:(67.9±8.2) nmol/L, AA:(68.8±3.2) nmol/L, F=9.285, P<0.001]. Low level (≤64.3 nmol/L) of EETs was an independent predictor of END (31.5-51.3 nmol/L group: OR=2.96,95% CI 1.18-8.77, P=0.02; 51.4-64.3 nmol/L group: OR=2.46,95% CI 1.06-6.89, P=0.03) in multivariate analyses. END was associated with a higher risk of poor outcome (modified Rankin Scale scores 3-6) at 3 months ( OR=1.82,95% CI 1.46-2.35, P=0.02). Conclusion:END is fairly common and associated with poor outcomes in acute MIS. EPHX2 gene variants may mediate EETs levels, and low levels of EETs are related to END in acute MIS.

Objective:To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China.Methods:In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12.Results:Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg +, 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95% CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion:In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

Objective To detect the expressions of nm23-H1 and heat shock protein 27 (HSP27) and their clinical significance on development and metastasis in non-small cell lung carcinoma (NSCLC).Methods 75 tumor tissues from patients with NSCLC were included as experimental group and 28 pulmonary benign lesion tissues were as control group.The expressions of nm23-H1 and HSP27 in patients with different clinical and pathological characters were detected by immunohistochemistry.Results nm23-H1 and HSP27 were mainly expressed in cytoplasm,the positive rates of nm23-H1 and HSP27 were significantly higher in the experimental group than that in control group [41.3 ％ (31/75) vs 7.1％ (2/28),x2 =10.946,P =0.001,80.0 ％ (60/75) vs 46.4 ％ (13/28),x2 =11.131,P =0.001].Compared with control group,the positive rate of HSP27 was correlated with the degree of tumor differentiation (x2 =4.191,P =0.041).nm23-H1 was related with HSP27 in lung cancer (r =0.284,P =0.013).Conclusion nm23-H1 and HSP27 are related to the occurrence and development of NSCLC.The joint detection of nm23-H1 and HSP27 should be helpful to the diagnosis and judge the biological behavior of NSCLC.

Objective To analyze the differences in microRNA (miRNA) expression between A549 and A549/DDP cells and explore the association between miRNA expression and drug resistance in non-small cell lung cancer (NSCLC).Methods The drug resistance of A549/DDP cells was evaluated using CCK-8 assay and flow cytometry.Microarray technique and RT-PCR were used to analyze the differential expression of the miRNA between A549 and A549/DDP cells.Enforced or inhibited target miRNA expression in cisplatin resistant cell was used to investigate whether miRNA involve in modulating the sensitivity of NSCLC cells to chemotherapeutic agent,exploiting the emerging knowledge of miRNA for the development of new human therapeutic applications for overcoming anticancer drug resistance and trying to discover biomarkers that were better able to predict the cancer chemotherapy sensitivity.Results The drug resistance index of A549/DDP cells relative to the parental A549 cells was 18.Microarray analysis of A549 and A549/DDP cells identified 51 differentially expressed genes (≥4-fold),including 24 up-regulated and 27 down-regulated genes in A549/DDP cells.RT-PCR identified 9 miRNA that were differentially expressed between A549 and A549/DDP cells.Of these differentially expressed miRNA,miR-376c,miR-31,miR-29a,miR-221 showed significantly increased expression,and miR-196a,miR-20a,miR-20b,miR-17,miR-451 showed significantlylowered expression in A549/DDP cells as indicated by the results of microarray analysis and RT-PCR.DDP sensitivity was increased 11.7 ％ in A549/DDP cells transfected with miR-17,but the chemosensitivity was decreased when miR-451 was over-expressed or miR-29a was inhibited by selective inhibitor,the reduction was 15.5 ％,12.9 ％,respectively,whereas chemosensitivity did not change when miR-376c,miR-31,miR-221 were inhibited or miR-196a,miR-20b,miR-20a were over-expressed.Conclusion A549/DDP cells show a different miRNA expression profile from its parental A549 cells,suggesting the involvement of miRNA in tumor cell drug resistance.miR-17 has the potential to be an efficient agent for preventing and reversing DDP-resistance in NSCLC.These results provide a strong rationale for the development of miRNA-based therapeutic strategies aiming to overcome cancer cell resistance.

Objective To study incidence of deep vein thrombosis (DVT) in the acute phase and follow-up period after stroke, and to investigate risk factors of DVT. Methods This was a prospective study at multi-centers. Ultrasonography was used for detecting DVT on both lower extremities in all patients at 10-14 days after the onset of stroke. All patients were followed up for 6 months after discharge. The incidence of DVT was examined in the acute phase and in the follow-up period of stroke. A variety of patient and treatment related factors were compared between stroke patients with DVT and without DVT to identify DVT risk factors. Results The incidence of DVT in the acute period of stroke was 4. 49%. Among DVT patients, 51.6% patients presented clinical DVT symptoms. By multiple factors logistic regression analysis,age ( ≥70 years, OR = 1.63, 95% CI 1.08-2. 84), bedridden( OR =4. 85, 95% CI 2.65-9. 68 ), wells score ≥ 2 ( OR = 3.96, 95% CI 1.86-7. 86 ), lower limbs NIHSS score ≥ 3 ( OR = 4. 56, 95% CI 2. 07-8. 85 ), high D-dimer ( OR = 3.45, 95% CI 2. 01-8. 52 ), low BI scores ( OR = 2. 98, 95% CI 1.52-6. 47 ), rehabilitation therapy ( OR = 1.82, 95% CI 1.22-3.43 ) and anticoagulant therapy ( OR =1.91,95% CI 1. 34-4. 92 ) were independent risk factors of DVT in the acute phase of stroke. Among them, the rehabilitation therapy and anticoagulant therapy were protective factors. The incidence of DVT in the follow-up periods was 1. 51%. Age ( ≥ 70 years, OR = 1.82, 95% CI 1.21-3.98 ), bedridden after discharge( OR = 5. 12, 95% CI 2. 82-11.32), lower limbs NIHSS score ≥3 ( OR = 4. 25, 95% CI 2. 11-7. 87), low BI score( OR = 2. 18, 95% CI 1.18-6.23 )at the time of discharge and DVT in acute period (OR =3.81,95%CI 1.87-7.48)were independent risk factors of DVT in the follow-up period of stroke.Conclusions Stroke patients, particularly old-aged stroke patients, are a high-risk group of developing DVT. 48.4% DVT patients had no clinical DVT symptoms but were diagnosed only by ultrasonography.There are multiple independent risk factors of DVT after stroke. It is necessary to monitor and prevent DVT in the stroke patients with the risk factors. The rehabilitation therapy and anticoagulant therapy may decrease incidence of DVT.