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Immunotherapy is the most promising treatment for hepatocellular carcinoma (HCC). However, the immunosuppressive microenvironment and necrosis limit its therapeutic effectiveness. Carbon nanotubes (CNTs) have good tissue permeability and can penetrate tumor necrosis area. Here we constructed a Durvalumab/CNT/PEI/aptamer-siRNA chimera (chimera/Durmab/CNT) nanoparticles for the immunotherapy of HCC.In vivoandin vitroexperiments showed that aptamer-siRNA chimeras could specifically bind HCC cells and inhibit the triggering receptor expressed on myeloid cells-2 (Trem2) expression, but had no effect on Trem2 expression in normal liver and lung. Transmission electron microscope results showed that the CNT/PEI nanoparticles were 20-30 nm in diameter and 200-350 nm in length. Dense PEI attachment can be observed on CNTs. CNT/PEI nanoparticles could control the sustained release of Durvalumab for 48 h.In vitroexperimental results showed that chimera/Durmab/CNT could increase the proportion of T cells and CD8 + T cells, and then promote the apoptosis of HepG2 cells, and the therapeutic effect was superior to aptamer/Durmab/CNT and Durmab/CNT. We constructed a tumor-bearing mouse model, and the results showed that chimera/Durmab/CNT significantly inhibited the growth of transplanted tumor, and the volume and proliferation was further reduced in the chimera/Durmab/CNT group compared with the aptamer/Durmab/CNT group. T cells and CD8 + T cells infiltration, and HCC cell apoptosis were significantly increased in the chimera/Durmab/CNT group. In conclusion, we constructed a Durvalumab/CNT/PEI/chimera, which can effectively treat HCC by activating anti-tumor immunity.

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Objective To explore the solution for regional population health information platform based on the involvement of internet plus and big data.MethodsThe objective and contents of the platform were discussed,and its logic structure and deployment architecture were designed.The functions of a platform-based application system and two information integration platforms were described.The key technical links of the system were demonstrated.Results The solution for regional population health information platform based on internet plus completed population health information service system,and laid a foundation for the application of medical big data.Conclusion The solution contributes to the inter-connection and communication between medical fields in some region,promotes healthcare informatizatoin platform and is thus worthy applying practically.

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Objective Microdialysis technique is a technology which can continuous monitoring of a substance′s metabolism level in specific tissues or organs,it can provide a series of substances monitoring of the liver transplantation,especially monitoring of glucose,lactate,glycerol,pyruvate and some amino acids. By the range of these substances, we can anticipate complications and ischemia?reperfusion injury after liver transplantation. In this paper we reviewed the principle, characteristics of the microdialysis technique and its applications of monitoring the ischemia?reperfusion and complications after liver transplantation,then pointed out the main problems and trends of the technology to provide a reference for further research in the field.

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Information security is the key in construction of digital hospitals and determines the successful diagno-sis and treatment of diseases in hospitals with information as a tool.The major problems in our hospital were imper-fect information security system , weak technique support , and insufficient implementation of regulations .The infor-mation security can be assured by constructing the security systems-for computer room, networks, data and their management , respectively .

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Microdialysis is an automatic biological sampling technique that is directed into the target tissue. Microdialysis is used to monitor the changes of drug and related substances associated with pathological physiology of tumor in the target tissue at the molecular level. Microdialysis is applied to evaluate the pharmaco-kinetics of drugs in the target tissue of tumor,optimize the combination therapy,explore molecular targeted therapy and study the early diagnosis and prognosis of tumor. Microdialysis provides a new idea and method for the prevention and cure research of tumor.

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Objective To study the influencing factors and clinical characteristic of High Intensity Focused Ultrasound(HIFU) abhtion analgesic in middle-late stage pancreatic carcinoma.Methods Seventyone cases pancreatic cancer patients underwent HIFU treatment were grouped according to the pain efficacy of related influencing factors and the data was analyzed by single factor correlation analysis.The relationship between influencing factors and analgesic effect were analyzed through the pain outcome score.Results Pain score decreased ≥50％ in advanced pancreatic cancer patients occurred in ＜60 years old,Body mass index (BMI) ＜ 22 kg/m2,tumor location in the pancreatic head and neck,tumor size of 2-5 cm,and the average power of HIFU treatment ＞ 400 W,Ductal adenocarcinoma of the tumor histological type were related to the degree of pain rehef,and the difference was statistically significant (P ＜ 0.05).And fewer complications occurred after HIFU ablation.Conclusion Analysis of the relationship between the different factors and the analgesic effect in advanced pancreatic carcinoma can be used to predict the efficacy of HIFU treatment.

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Objective To investigate the therapeutic effect and safety of high intensity focused ultrasound(HIFU) combined with Gemcitabine in treating unresectable pancreatic carcinoma Methods Forty one patients suffering from unresectable pancreatic carcinoma were randomly divided into two groups.The patients in experimental group(n =21) were provided with HIFU in combination with gemcitabine therapy and those in control group(n =20)received HIFU treatment alone.The effect,clinical benefit rates,changes of tumor marker carbohydrate antigen 19-9(CA19-9)and adverse reactions were compared between these two groups.The median survival time,6-month and 12-month survival rates were calculated by Kaplan-Meier method and Logrank test.Results The median survival time,6-month and 12-month survival rates were 10.22 months,76.2％(16/21) and 42.9％(9/21) in experimental group,and they were 7.43 months,50.0％(10/20) and 15.0％(3/20) respectively in control group.Among them,12-month survival rates was significantly higher in experimental group than that in control group(x2 =4.00,P ＜ 0.05).The clinical benefit rates in experimental group were significantly higher than that in control group[76.2％(16/21) vs 45.0％(9/20),x2 =4.20,P ＜0.05].But there was no significant difference on pain remission rate between the two groups(66.6％ vs45.0％,P ＞ 0.05).There was significant difference on CA19-9 after treated for 2,3,4,5 and 6 months in experimental group than that in control group(t =2.225,2.133,1.743,2.599,2.278,respectively,P ＜ 0.05)Conclusion HIFU in combination with Gemcitabine therapy is better than application of HIFU treatment alone.The former may become of the most effective treatmenffor unresectable pancreatic carcinoma.

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High intensity focused ultrasound (HIFU)is a new technology of focal therapy for patients with hepatic carcinoma.Comparing with operation and other focal therapeutic methods (such as radiofrequency and transcatheter arterial chemoembolization) of liver cancer,HIFU is non-invasive,accurate,and definite in killing the tumor tissue with fewer complications.Thus,it is widely accepted in clinical settings and has a promising prospect.In this article,we review the mechanism and present situation of hepatic carcinoma therapy with HIFU and dicuss some clinical application and development in the future.

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Objective To investigate the therapeutic effect and the immune function impacts of high intensity focused ultrasound(HIFU) for the treatment of hepatocellular carcinoma.Methods Twenty-five cases with primary liver cancer and 6 cases with metastatic liver cancer were treated with HIFU.The clinical symptoms,AFP levels,color Doppler ultrasound detection,CT and changes of T-cell subsets ( CD3 +,CD4 +,CD8 +,CD4 +/CD8 + ) were recorded before and after treatment.Results After HIFU treatment,among 31 patients,the clinical remission rate was 89.7％ ( 25/29 ).AFP was decreased in 83.3％ ( 15/18 ) of the patients.Color Doppler showed reduced tumor sizes and reduced or disappeared blood supply in most of the patients.CT scan displayed that the density of the target region was decreased and necrosis of the lesions occurred.The percentage of CD3 + and CD4 + cells and the ratio of CD4 +/CD8 + were significantly increased after a period of treatment( P ＜0.05 ).The proportion of CD8 + cells was decreased significantly after a period of treatment ( P ＜ 0.05 ).Conclusion HIFU is an effective technique for the treatment of hepatocellular carcinoma.Meanwhile,it can improve human immune function to certain extend.

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To investigate the biomechanical behavior of human intestines. The tensile test human intestine was performed with the electronic tension machine in this paper. The results indicate that the exponential relationship for the stress-strain of the human intestine was obtained, and the exponential coefficient a of each segment of the intestine is almost the same although the constant C is different. It also shows that the relative rate of stretch length of each segment intestines is different in longitudinal and circumferential directions. And the incremental elastic modulus of colon is less than those of small intestine. It is considered that the colon can be more easily deformed. The experimental results provide the theoretic basis for research on intestinal endoscopic microrobot.

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To probe further into the viscosity of gastrointestinal mucus, the samples of gastrointestinal mucus were taken from fifty normal people and were tested with Low-Shear 30 viscometer, and then the viscosity model was obtained. The results indicated that the apparent viscosity of large intestine mucus is greater than that of small intestine and stomach. The gastrointestinal mucus is a kind of non-Newtonian fluid when its apparent viscosity rapidly decreases with the increase of shear rate. When the shear rate increase well enough, the apparent viscosity of gastrointestinal mucus becomes a constant, and the gastrointestinal mucus appears to be a Newtonian fluid.

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Objective To study the diagnostic value of endoscopy assisted by laparoscopy in patients with small intestinal bleeding. Methods In case of small intestinal bleeding it is hard to define the accurate etiological factor by routine examination. From 1994 to 2002 there were 14 patients with chronic me-lena or persisted melena complicated with chronic anemia and 2 cases of acute alimentary tract hematorrhea complicated with obvious hypovolemia. Results Endoscopies assisted by laparoscopy were accomplished in all of the 16 cases. Lesions were detected in 5 cases with laparoscopy directly, and in 11 cases the pathological changes were discovered by endoscopies assisted with laparoscopy . The pathologic results were leiomyo-sarcoma 1 cases, leiomyoma 4 cases, adenoma of small intestine , hemangioma , vascular malformation and capillary telangiectasia 2 cases each, and Meckels diverticulitis with hemorrhage 3 cases. Conclusion The diagnostic value of endoscopy assisted with laparoscopy is superior to the routine examination in detecting the small intestinal bleeding. This technique has the advantage of simple, less-traumatic and high sensitivity. It is worthy to popularize in clinical practice.

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Objective To evaluate the effect of various herniorraphy in treating inguinal hernia. Methods The clinical data of 108 patients who underwent conventional Bassini herniorraphy (BH), tension free herniorraphy (TH), or laparoscopic herniorraphy (LH),respectively were analysed and comparated. Results The operation time in TH was less than that in BH, and in LH was longer than that in TH. The ability recovery, hospita stay and postoperative complication in TH and LH were less than those in BH.All the patients were followed up for at least 1 year.Of them, 1 recurred after BH, but there was no recurrence after TH and LH. The blood neutrophils, serum level of fibrin, C-reactive protein and alpha-1 antitrypsin increased significantly in the patients undergoing herniorraphy, which were significantly higher in the patients underwent TH and LH. Conclusions The curative effect of TH and LH is much better than that of BH in treating ingumal hernia. Application of marlex for herniorraphy might increase inflammation response, but it will not increase the incidence of infection.