Objective To identify dosimetric predictors for the development of gastrointestinal toxicity in patients with pancreatic adenocarcinoma treated with TOMO radiotherapy.Methods From January 2014 to January 2015,we analysed the medical records of 68 pancreatic cancer patients who received helical tomotherapy from Air Force General Hospital.The stomach and duodenum were contoured separately to determine their dose volume histogram(DVH)parameters.Chi-square test was employed to analyze the count data.Spearman correlation analysis was used to analyze the relationship between occurrence of gastrointestinal toxicity and clinical and physical factors.Logistic regression models was performed to identify risk factors associated with gastrointestinal toxicity.Results The median follow-up was 9 months(4~16months).18 patients experienced grade II acute gastrointestinal toxicity,1 patient experienced grade Ⅲ acute gastrointestinal toxicity,whereas 17 patients experienced grade II late gastrointestinal toxicity,1 patient experienced grade Ⅲ late gastrointestinal toxicity.On UVA,the volume,Dmean,D1,D3,D5,D10,V5 to V40,and V5′ to V45′ of duodenum were significantly associated with Grade Ⅱ or higher gastrointestinal toxicity(P＜0.05).The MVA,V45′ of duodenum was independent predictor for grade Ⅱ or higher gastrointestinal toxicity(P＜0.05).The ROC analysis also showed that V45′ of 0.5cm3 was the optimal threshold to predict for gastrointestinal toxicity for the entire cohort.Conclusion V45′ of duodenum is of greater importance in the judgment of occurrence of hypofractioned radiation-induced gastrointestinal toxicity.

Objective To investigate the molecular mechanisms of effect of glycogen synthase kinase-3beta(GSK3β)on proliferation of human osteosarcoma cells.Methods Normal osteoblast hFO and osteosarcoma cell lines were examined for GSK3β expression and activity by Western blot and in vitro kinase assay(NIRKA).The effects of small molecule GSK3β inhibitors on cell proliferation and apoptosis were examined.Depletion of endogenous GSK3β by GSK3β siRNA detected the expression and phosphorylation of p27 and its downstream cyclinD1-CDK-Rb pathway factor by Western blot.Human osteosarcoma cell xenografts,in athymic mice model,were treated with DMSO as control or with GSK3β inhibitor SB-216763 or AR-A014418 by intraperitoneal injection,3 times a week.The tumor growth and body weight were observed in nude mice.Results Osteosarcoma cell lines showed increased GSK3β expression and decreased serine 9 phosphorylation compared with normal osteoblast cells.Inhibition of GSK3β resulted in attenuated cell proliferation and increased apoptosis in most osteosarcoma cell lines in vitro and in vivo in MG63 xenografts in rodents but not in hFOB cells.We decreased endogenous GSK3b activity,tumor growth was inhibited in SB216763,AR-A014418 group compared with control group.There was statistical significance(P＜0.05).GSK3β inhibition in osteosarcoma cells was associated with decreased p27 expression,Rb expression and phosphorylation level of decline,CDK2,4,6 protein level decreased,the upregulation of cyclin D1 expression but the phosphorylation level of no effect.Conclusion In this research,we demonstrate that deregulated GSK3β sustains osteosarcoma cells survival through modulation of p27and cyclinD1-CDK-Rb pathway.The result will open up a potential target for clinical treatment of osteosarcoma.

Objective To investigate the correlation between(CAG)n repeat polymorphism of androgen receptor(AR)gene and male breast cancer.Methods 40 cases of male breast cancer and 40 controls were collected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplification,sequencing and calculated the number of CAG repeats frquency.χ² test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk.Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared(CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk.Longer CAG repeats can increase the risk of male breast cancer.

Objective To investigate the clinical value and adverse reactions of indwelling ureteral stents in the prevention of ureteral injury before complex pelvic tumor surgery.Methods 145 cases of patients with rectal cancer,cervical cancer,ovarian cancer and pelvic sarcomas were retrospectively analyzed,and 53 patients with complex pelvic tumor surgery,preoperative were under cystoscope unilateral or bilateral ureteral stent tube,pulled out according to the intraoperative situation after surgery or lien,92 patients as control group.Results Ureteral injury was found in 10 of the 145 patients,2 cases in ureteral catheter group and 8 cases in control group.3 cases of postoperative ureteral fistula occurred in the control group.Indwelling ureteral stents could cause adverse reactions such as hematuria,osphyalgia and urinary irritation,and the adverse reactions of catheter group was obviously higher than that of control group(P＜0.05).Conclusion Cystoscopic ureteral stent placement has important clinical significance for prevention of ureteral injury despite certain adverse reactions,which can be used in operation of complex pelvic tumor.

Objective To study the expression of acid secreted proteins that are rich in cysteine protein(SPARC protein)in gastric adenocarcinoma tissue and its relationship with the prognosis of patients with gastric cancer.Methods In order to detect SPARC protein expression levels in gastric adenocarcinoma,104 primary gastric adenocarcinoma samples as well as 30 normal gastric tissues adjacent to carcinoma were studied by immunohistochemistry.Results The positive rate of SPARC protein in 30 cases of gastric mucosa adjacent to carcinoma is 20%,and with weak expression or no expression;The positive rate in 104 cases of gastric cancer tissues was 76.1%,the difference was significant(P＜0.01).The high expression rate of SPARC and lymph node metastasis in gastric adenocarcinoma were positively correlated(P＜0.01).The SPARC expression rate of well and moderate differentiation of gastric adenocarcinoma were significantly lower than that of the low differentiation(P＜0.05).The average survival time of gastric cancer patients with high SPARC expression was 27.4 months.However,the average survival time of the patients with low SPARC expression was 40.9 months.The difference was significant(P＜0.05).Conclusion SPARC protein is mainly high expressed in gastric cancer stromal tissue cells and fibroblasts.The expression level of SPARC protein is significantly associated with lymph node metastasis and tumor differentiation degree.The high expression of SPARC patients survival time is short and the prognosis is poor.However,SPARC protein is not an independent prognostic factor.

Objective To investigate the expression of microRNA-216a(miR-216a)in patients suffering with breast cancer,and identify the function and mechanism of miR-216a on autophagy.Methods The expression of miR-216a in 30 tumor tissues and paired normal tissue of breast cancer were detected by qRT-PCR.Inhibiton of miR-216a in MCF-7 cell lines was done by transfection of miR-216a inhibitor(AMO-216a).Cell viability was detected by MTT assay.The level of Beclin 1 was detected by western blot.Results The level of miR-216a was significant elevated in tumor tissue.Cell viability was markedly decreased owing to inhibition of miR-216a in MCF-7 cells.The level of Beclin 1 was significantly increased by transfection of miR-216a inhibitor in MCF-7 cells(P＜0.05).Conclusion The level of miR-216a is increased in breast cancer tissue,and it might at least in part promote breast cancer via downregulating Beclin 1 and affecting autophagy.

Objective To explore the independent influencing factors on the survival of patients with cervical cancer.Methods Five hundreds and nintheen surgery patients with cervical cancer,and hospitalized in the Tumor Hospital Affiliated to Harbin Medical University between January 2007 and December 2008 were chosen as our research object.We analyzed the influence of different biological behaviors on the outcome of patients with cervical cancer by using univariate and multivariate COX regression,and then explored the prognostic factors of patients with cervical cancer.Results Among all biological behaviors,tumor size(P=0.015),lymph node metastasis(P＜0.001),ovarian metastasis(P＜0.001),utero-tissue infiltration(P＜0.001),vaginal stump(P=0.040),myometrial in-vasion(P=0.001)and lymph vascular space involvement(P＜0.001)affected patients′ outcomes significantly.The results of univariate COX regression showed that the tumor size(RR=2.325),histological grade(RR=3.195),lymph node metastasis(RR=3.196),ovarian metastasis(RR=7.016),utero-tissue infiltration(RR=7.487),myometrial invasion(RR=4.688)and lymph vascular space involvement(RR=4.014)were significantly associated with the prognosis of cervical cancer.In addition,the results of multivariate COX regression indicated that histological grade(RR=2.092),ovarian metastasis(RR=5.680),utero-tissue infiltration(RR=4.114),myometrial invasion(RR=2.065)and lymph vascular space involvement(RR=3.11)were significantly associated with the prognosis of cervical cancer.Conclusion Histological grade,ovarian metastasis,utero-tissue infiltration,myometrial invasion and lymph vascular space involvement were independent influencing factors of prognosis of cervical cancer.

Objective To analyze the value of diffusion weighted imaging(DWI)in assessing the effect of neoadjuvant chemotherapy of uterine cervix cancer.Methods Thirty one patients with LACC confirmed by pathology received conventional magnetic resonance imaging and DWI before and after neoadjuvant chemotherapy.The variation of DWI image and ADC was evaluated before and after chemotherapy.Results The correlation between maximum diameter of the tumor before treatment(37.10±11.23)and pretreatment ADC value(0.83±0.12)was not statistically significant(correlation coefficient r=-0.1746,P=0.3475);the correlation between the maximum diameter of the tumor(24.03±5.65)and ADC value(1.10±0.16)after treatment was not statistically significant(correlation coefficient r=-0.2077,P=0 2621.);the degree of tumor size before and after the treatment was correlated with the degree of ADC increase(P＜ 0.05);Effective chemotherapy group of 20 cases,invalid group of 11 cases,ADC value of effective treatment group after treatment(0.95±0.13)was significantly higher than ADC value before chemotherapy(0.80±0.12),the change was statistically significant(P＜0.05),while the difference between former ADC value(0.88±0.10)and ADC value after treatment(0.95±0.13)of ineffective group therapy was not statistically significant(P＞0.05).Conclusion DWI sequence may be useful for early prediction and evaluation of curative effect to neoadjuvant chemotherapy for uterine cervical cancer.

Objective To investigate the influence of fast track surgery on stress and inflammatory response in breast cancer patients treated with modified radical mastectomy.Methods Ninety nine patients with breast cancer undergoing modified radical mastectomy were allocated randomly to fast track surgery group(46cases)and general group(53cases).The concentrations of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8,TNF-α of each group were measured before operation,12 hour,24hour and 48hour after operation by radioimmunoassay method.Operation time,operative blood loss and hospitalization days were analyzed between the two groups,simultaneously,the incidence of subcutaneous hydrops,flap necrosis and upper limb edema were also detected.Results The concentration of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-α were no significantly differences in two groups before operation and at 48 hours after surgery(P＞0.05).The concentrations of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-α of FTS group were significantly different between the preoperative and different time points(P＜0.05).The concentration of serum PRA,Ang-Ⅱ,ALD,cortisol,IL-6,IL-8 and TNF-α of FTS group were lower than that of control group at the same time point(P＜0.05).The operative time was(158.32±22.47)mins in FTS group and(161.32±22.37)mins in control group,respectively,and there were no significant statistical differences(P＞0.05).The intraoperative blood loss in the FTS group(156.98±17.09)ml was not significantly less than that in the control group(158.57±16.92)ml(P=0.644).Hospitalization days were 8.37±1.89 and 10.37±2.05 in the FTS and the control group respectively,with significant difference.The incidence of upper limb edema,subcutaneous hydrops,flap necrosis in FTS group were not less than control group.Conclusion Fast track surgery could attenuate stress and inflammatory response during,and it is safe and effective in modified radical mastectomy.

Objective The relationship between fever and the recent curative effect of transcatheter arterial chemoembolization(TACE)and the related factors of fever after transcatheter arterial chemoembolization in large hepatocellular carcinoma is discussed in this paper.Methods One hundred and twenty patients with large liver cancer were divided into two groups according to the fever after TACE.The fever in group A,and there was no fever in group B after TACE.The changes of the lesions in the two groups were compared after the first interventional treatment.The factors affecting the fever after TACE were analyzed.Results The CT was performed at about one and half month after the first intervention.The curative effects of A and B were evaluated by RECIST criteria.Two groups of CR,PR,SD,PD were 0,11.11%,71.11%,17.78% and 0,0,33.33%,66.67%,respectively.The difference of the efficiency of OR was statistically significant(P=0.049).The probability of fever of four types of iodine oil deposits are as follows:100%,93.33%,81.93%,0.Blood supply type,middle and severe hepatic arteriovenous fistula,the use of gelatin sponge,tumor necrosis,and the use of iodine oil were more than 25ml may be factors affecting postoperative fever.Conclusion The clinical symptoms of fever after TACE suggest that the lesion is well embolization and iodine oil deposit is good,and the lesion is not easy to progress,and short-term curative effect is better.The analysis of the factors that affect the postoperative fever may help to evaluate the curative effect of patients with large hepatocellular carcinoma.

The hydroa vacciniforme-like lymphoma is clinically manifested by rash,fever,hepatosplenomegaly and lymphadenectasis.Pathological character showed that lymphocytes infiltrated into dermis and there were some heterocysts.Immunohistochemistory showed that Bcl-6,Bcl-2,CD3,CD8,TIA,CD4,granzyme,EBER were positive,CD56,CD20 all tested negative.The rearrangement of TCR of bone marrow cell was positive.The hydroa vacciniforme-like lymphoma is uncommon clinically,and it is easy to misdiagnosed.The effect of traditional therapy is poor,while the allogeneic hematopoietic stem cell transplantation followed by lymphocyte and donor-derived EBV-specific cytotoxic T-lymphocyte immunotherapy is effective,which may offer an curable therapy for HVLL.

Second primary malignancies are more likely to occur in the multiple myeloma patients.Most of them are Acute myeloid leukemia(AML)or Myelodysplastic syndrome(MDS).The incidence in male or those multiple myeloma patients who is less than 60 years old are more than female or those multiple myeloma patients who are bigger than 60 years old.In recent years,studies of multiple myeloma secondary to leukemia and other tumors are gradually increasing,but the mechanism and treatment are still unclear.These diseases have the following characteristics such as progress rapidly,high mortality rate and low complete remission rate after chemotherapy.

NF-κBs is a member of Rel protein family of transcription factors,which is expressed in all cells and is involved in important physiological and pathological regulatory mechanisms,including the regulation of TLR3 on NF-κB signaling pathway,which has been attracted widespread attention.This paper reviews the molecular mechanisms of the regulation.We summarizes the role of host immune responses in tumor development,which is mediated by the related signal molecules.It reveals that some key proteins in the regulation have a great significance to the treatment of diseases,as used as the therapeutic targets,and is conducive to the understanding of function and diversity in tumor tissue.

Squamous cell carcinoma is the second most common non-melanoma skin cancer and its morbidity is increasing in recent years.Because of the complicated pathogenesis and non-specific clinical manifestation of squamous cell carcinoma,misdiagnosis occurs frequently.Although squamous cell carcinoma usually grows very slowly,the invasion and metastasis of special types occurs early.With the deep knowledge of squamous cell carcinoma,people get more and more research results in diagnosis,treatment and prevention.This paper describes the epidemiology,etiology,clinical manifestation,pathology,clinical staging,treatment and prognosis.

Growth of tumor need new blood vessel to meet the demand for adequate oxygen and nutrients.Inhibiting the formation of blood vessel can inhibit growth of tumor.In all of the endogenous angiogenesis inhibitors deriving from the type IV collagen.Study of tumstatin is the most widely.Tumstatin can inhibit endothelial proliferation and induce the apoptosis of endothelial cell.This article reviews the research status of the tumstatin.

Many long non-coding RNA(lncRNA)has been found in recent years.The abnormal lncRNA expression is closely related to the occurrence and development of tumor.LncRNA can be divided into the tumor promoting and tumor inhibiting according to the function.lncRNA generally overexpresses in solid tumor tissue,acts as an important factor involved in tumor invasion,proliferation and metastasis,and has been associated with prognosis of neoplasm.This paper describes the current situation of lncRNA research.We mainly introduce several functions of lncRNA which thoroughly researched at present(such as HOTAIR,H19,MALAT-1,LincRNA-p21,GAS5,etc)and their expression in colorectal tumor tissue,indicating that regulating the expression level of lncRNA may provide a new basis for the diagnosis and treatment of colorectal cancer.

Primary tracheal tumor is an uncommon disease in clinical oncology.It tends to be misdiagnosed in very early stage,as well as lack of standards for staging and treatment nowdays.The main strategy for the treatment of primary tracheal tumors is surgical comprehensive treatments.But as the huge development of modern radiotherapy technology the past a few years,radiotherapy could play more and more important roles in the treatment of tracheal tumors.Meanwhile,the application of tracheal scaffold have provided the patients with tracheal tumors some new choices on the treatments.Yet,there are no guildline for the standard of the surgery,the dose of the radiotherapy and the definition for the tumor target volumes.Here,we give a review on the latest process and research on the treatment of primary tracheal tumors.

Cancer is like a planet,which consists of a heterogeneous mixture of distinct cancer cells.Cancer planet includes four varying levels:niche,surface,middle and core.Cancer architecture based system therapies are starting to be exploited for the development of novel strategies to war for cancer.

Currently,XB130 as a newly discovered characterized adaptor protein,it has been implicated as a substrate and regulator of many intracellular signal transduction,such as FAK/SRC,PI3K/Akt and MEK-ERK signaling and so on.It has been found that XB130 is high expression in many cell lines,for instance thyroid carcinoma,osteosarcoma,gastric cancer,esophageal cancer and breast cancer etc.The mechanism of XB130 in tumor is becoming increasingly attention.XB130 is recently attributed to be a new oncogene,and plays important roles in cell pro-liferation,cell survival and tumorigenesis.A deeper understanding of these mechanisms may lead to the discovery of XB130 as an important mediator in tumor development and as a novel therapeutic target for cancer.

We have confirmed that many of the intraepithelial neoplasia confined to in situ may never be found in some patients,such as breast,prostate and lung lesions,but few of these lesions progress to malignancy are unexplained.Studies demonstrate that many invasive neoplasia and its precancerous lesions with similar genes changes,which provide the necessary premise for the late tumor metastatic,just like specific promoter mutations driving the cancer development,but the current radical view is that the mutations of the genes are not the driver of cancer development,rather the microenvironment of the cells inhibits or promotes the development of tumor.General view is that the epithelial cells are changed before the cell matrix in the development of neoplasia,but recent evidences show that the cell matrix is the first to change.This paper will focus on how matrix changes affect the epithelial tumor development,and this will bring new breakthrough for controlling epithelial tumors.

Locally advanced nasopharyngeal carcinoma(NPC)invaded with paranasal sinus as death is associated with disease and independent prognostic factors for local recurrence.Its symptoms are various and atypical,and often causes misdiagnosis or missed diagnosis.Local recurrence and distant metastasis are the main cause of treatment fails.Currently,there are few literature about NPC intruding paranasal sinus.Its occurrence rate,clinical manifestation,imageological change,intruding pathways,diagnosis,treatment and prognosis are summarized in this paper.