Objective   To explore the relationship between MALAT1 and miR-205 and to reveal the molecular mechanism of MALAT1 to promote the occurrence and development of osteosarcoma. Methods   Real time fluorescence quantitative PCR （QPCR） was used to detect the expression of MALAT1 and miR-205 in osteosarcoma tissue， paracancerous normal tissue， human osteoblasts （hFOB）， and MG63 and Sao-2 osteosarcoma cells. Bioinformatics and fluoro enzyme experimental was used to observe the targeting regulation of miR-205 by MALAT1. After transfection of miR-205 mimics to Sao-2 and MG63 cells， the expression of MALAT1 was detected by QPCR. After transfection of si-MALAT1 to Sao-2 and MG63 cells， the expression of miR-205 was detected by QPCR. MG63 cells were transfected by miR-205 mimics and si-MALAT1 respectively. The ability of invasion and metastasis was detected by Transwell compartment， and the expression of MMP-2 and MMP-9 was detected by Western blotting assay. Results  The expression level of MALATI and miR-205 in osteosarcoma tissue， paracancerous normal tissue were 4.7±0.6，2.6±0.08 and 2.2±0.09，3.7±0.3（P＜0.05）. The expression of MALAT1 and miR-205 in hFOB, MG63 cell line and Sao-2 cell line were 0.9±0.01, 2.4±0.7, 2.1±0.05 and 0.82±0.04, 0.53±0.04, 0.47±0.02（P＜0.05）. Bioinformatics and luciferase detection showed that there were three complementary sequences of miR-205 in the MALAT1 sequence， and both of them had a targeting regulation. The expression of miR-205 in Sao-2 and MG63 cells transfected with si-MALAT1 were 3.4±0.7 and 3.8±0.6， while that in the control group was 1.4±0.5 and 1±0.1. The difference was statistically significant （P＜0.05）. The expression of MALAT1 in Sao-2 and MG63 cells transfected with miR-205 mimics was 0.51 ± 0.05， 0.42 ± 0.03， while the control group was 1.5 ± 0.7， 1.28 ± 0.4. The difference was statistically significant （P＜0.05）. The number of MG63 cells invasion in miR-205 mimics group was 28.52 ± 3.68， which was lower than that in miR-205 and pMALAT1 co-transfection group （42.63 ± 5.67）， the difference was statistically significant （P＜0.05）. The expression levels of MMP-2 and MMP-9 in miR-205 mimics group were 0.41 ± 0.02， 0.49 ± 0.04， which were significantly lower than those in miR-205 and pMALAT1 co-transfection group， the difference was statistically significant （P＜0.05）. Conclusion  There is a bi-directional inhibition relationship between MALAT1 and miR-205， and MALAT1 promotes the invasion and metastasis of osteosarcoma cells by inhibiting the expression of miR-205.

Objective   To investigate the effect of miRNA-152 （miR-152） on adriamycin sensitivity of breast cancer cells and its mechanism. Methods  The levels of miR-152 in human breast epithelial cell line HBL-100， human breast cancer MCF-7 cells and adriamycin resistant MCF-7／ADR cells were detected by real-time quantitative PCR （QPCR）. MCF-7 and MCF-7／ADR cells were transfected with miR-152 mimics （overexpression group） or negative control （negative control group）， and no transfection was used as blank control group. The expression of miR-152 in MCF-7 cells and MCF-7／ADR cells after transfection were detected by QPCR. The proliferation of cells treated with different concentrations of adriamycin（10, 50, 100, 200 and 500 ng/ml） was detected by MTT， and the apoptotic rate after transfection was detected by flow cytometry. Western blotting was used to detect the protein level of phosphatidylinositol-3-kinase catalytic subunit α （PIK3CA）. The target regulation of miR-152 on PIK3CA was evaluated by the double luciferase report test. Results  QPCR Results  showed that miR-152 levels in MCF-7 cells and MCF-7／ADR cells were all lower than those in HBL-100 cells， and miR-152 levels in MCF-7／ADR cells were lower than that in MCF-7 cells （P＜0.05）. The levels of miR-152 after transfection in overexpression group were higher than those in the negative control group and the blank control group （P＜0.05）. Compared with other two groups， the survival rate and the PIK3CA protein level of the overexpression group decreased and the apoptotic rate increased （P＜0.05）. MiR-152 could inhibite the luciferase activity of the wild-type PIK3CA 3’UTR reporter gene， but had no effect on the luciferase activity of the mutant PIK3CA 3’UTR. Conclusion  The expression of miR-152 is decreased in breast cancer cells， and is related to adriamycin resistance in breast cancer cells. It is involved in the proliferation and apoptosis process of breast cancer cells， and plays an important role in reversing the drug resistance of breast cancer.

Objective   To detect the expression of erythropoietin （EPO） and erythropoietin receptor （EPOR） in hepatocellular carcinoma （HCC） tissues and analyze their predictive value on the prognosis of HCC patients. Methods   Immunohistochemistry technique was used to detect the expression of EPO and EPOR in 96 cases of HCC tissues and 11 cases of normal liver tissues. The difference of the expression of the two proteins in two tissues and the correlation of the expression of the two proteins were analyzed. Also， the relationship of the two proteins with clinicopathological features and prognosis of HCC patients were analyzed. Results  The high expression rates of EPO and EPOR were 49.0％and 46.9％ in 96 cases of HCC tissues， higher than 0 and 0 in normal liver tissues. The expression of EPO was positively associated with that of EPOR（r=0.207， P＜0.05）. The expression of both EPO and EPOR was associated with Edmondson-Steiner histological grade（P＜0.05）. The 1-，3- and 5-year disease free survival rates were 76.2％，42.1％ and 16.5％ in low EPOR expression group， significantly higher than 55.6％， 14.0％ and 7.8％ in high EPOR expression group （P＜0.05）. Similarly， the 1-，3- and 5-year overall survival rates in low EPOR expression group were 88.0％， 76.0％ and 46.1％， significantly higher than 80.0％， 43.6％ and 26.8％ in high EPOR expression group（P＜0.05）. Multivariate analysis revealed that satellite nodules， the expression of EPOR were independent risk factors of disease free survival（P＜0.05）， and satellite nodules， vascular invasion and the expression of EPOR were independent risk factors of overall survival（P＜0.05）. Conclusion  The expression of EPOR is correlated with disease free survival and overall survival of HCC patients， and maybe a prognosis biomarker of HCC.

【Abstract】Objective   To investigate the expression of lncRNA SNHG5 in hepatocellular carcinoma（HCC） tissues， and explore its biological regulation on cell proliferation and cell apoptosis. Methods   The mRNA expression level of SNHG5 in hepatocellular carcinoma tissues and adjacent normal tissues was determined by QPCR. Then HepG2 cells were transfected with siRNA to knockdown the expression of SNHG5. CCK-8， flow cytometry， QPCR and Western blotting were used to detect the biological characteristics of proliferation and apoptosis of HepG2 cells， as well as the changes in the expression level of apoptosis pathway related markers. Results  The expression level of SNHG5 in HCC tissues was significantly higher than that in matched adjacent tissues （P＜0.05）. After knocking down SNHG5 expression， the proliferation and anti-apoptotic ability of HepG2 cells were inhibited， and the expressions of apoptotic proteins cleaved caspase-3 and BAX were upregulated. Conclusion   SNHG5 was found to be overexpression in liver cancer tissues. SNHG5 might play as a potential therapeutic targetby regulating proliferation and apoptosis of HCC.

Objective   To explore the expression of microRNA-98 （miR-98） and microRNA-183 （miR-183） in gastric cancer and their clinical significances. Methods  From January 2013 to December 2016， 90 cases of gastric cancer tissues and paired adjacent tissues were collected in our hospital. Quantitative real-time PCR （QPCR） was performed to evaluate the expression of miR-98 and miR-183. The relationships between levels of miR-98 and miR-183 with the clinicopathological parameters （sex， age， lymph node metastasis， differentiation， distant metastasis， TNM staging， depth of infiltration， Lauren typing and tumor size） were analyzed. The receiver operating characteristic curve （ROC） was used to analyze the value of both alone and combined in predicting gastric cancer. Pearson correlation analysis was used to analyze the correlation between miR-98 and miR-183 expression. Results   The expression levels of miR-98 and miR-183 in cancer tissues were 1.567±0.124 and 0.629±0.097， respectively. Compared with adjacent tissues， there were upregulated levels of miR-98 but downregulated levels of miR-183 in gastric cancer tissues （P＜0.01）. Meanwhile， there was a negative correlation between miR-98 and miR-183 （r=-0.2995， P=0.004）. The expression of miR-98 was related to lymph node metastasis and differentiation， while miR-183 expression was related to lymph node metastasis， distant metastasis and tumor size （P＜0.05）. The ROC curve analyses revealed that miR-98 had considerable diagnostic accuracy， yielding an AUC （area under curve） of 0.794 with 61.11 ％ sensitivity and 95.56％ specificity in discriminating gastric cancer tissues. The AUC of miR-183 was 0.824 with the sensitivity and specificity of 76.67％ and 76.67％. The AUC of combination of miR-98 and miR-183 was 0.903 with sensitivity and specificity of 74.44％ and 91.11％. Conclusion   MiR-98 is highly expressed in primary gastric cancer， while miR-183 is abnormally low， and there is a negative correlation between miR-98 and miR-183. Both miRNAs are related to metastasis and differentiation in gastric cancer. These findings indicate that miR-98 and miR-183 might serve as the potential biomarker for the detection of gastric cancer.

Objective To investigate the relationship between the expression of PI3K， Akt and Survivin and clinicopathological features and prognosis in gastric cancer， and to provide theoretical basis for the diagnosis and prognosis evaluation of gastric cancer. Methods  The expression levels of PI3K， Akt and Survivin were detected in 75 gastric cancer tissues using En Vision immunohistochemical method.The relationship between the expression and the clinicopathological features was analyzed. In addition， Spearman correlation test was used to analyze the relationship between the expressions of PI3K， Akt and Survivin. Survival analysis was performed by Kaplan-Meier method， and Cox multivariate regression analysis was used to identify the independent prognostic factors of gastric cancer. Results  In gastric cancer tissues， the positive rates of PI3K， Akt and Survivin were 73.3 ％（55／75）， 38.7％ （29／75） and 61.3 ％（46／75） respectively. The expression of PI3K， Akt and Survivin was related to the degree of differentiation， TNM staging and lymph node metastasis （P＜0.05）， but not with sex， age， size of the mass， and the level of CEA before treatment （P＞0.05）. The expression of PI3K was positively correlated with Akt and Survivin expression （r=0.293， P＜0.05； r=0.450， P＜0.05）. PI3K， Akt，  Survivin， differentiation， TNM staging and lymph node metastasis were correlated with prognosis in gastric cancer. Cox regression analysis showed that Survivin， lymph node metastasis were independent prognostic factors of gastric cancer （P＜0.05）. Conclusion  The expression of PI3K， Akt and Survivin is closely related to the invasion and metastasis of gastric cancer. There may be a synergistic effect between PI3K and Akt， PI3K and Survivin， which jointly promote the malignant progression of gastric cancer. Survivin is one of the independent factors that affect the prognosis of gastric cancer.

Objective  To investigate the expression of doublecortin-like kinase 1 （DCLK1） and B-cell specific moloney leukemia virus insertion site 1（Bmi-1） in colorectal cancer and their clinical significance. Methods  The expression of DCLK1 and Bmi-1 were detected in the 74 cases of colorectal cancer and the corresponding adjacent normal tissues by Max Vision method. The correlation between the expression of two protein and their relationship with clinical pathological parameters of colorectal cancer were analyzed. Results   The positive expression rates of DCLK1 and Bmi-1 in colorectal cancer were 68.9％ and 62.2％， higher than 27.0％ and 23.0％ in their adjacent normal tissues respectively， and the differences were significant （P＜0.05）. DCLK1 was significantly correlated with infiltration’s depth， lymphatic metastasis and Dukes’ stage in colorectal cancer（P＜0.05）. Bmi-1 was signifcantly correlated with tumor classification, infiltration’s depth, lymphatic metastasis and Dukes’ stage（P＜0.05）. The expression of DCLK1 was positively correlated with that of Bmi-1 （r=0.259， P=0.026）. Conclusion   DCLK1 and Bmi-1 were highly expressed in colorectal cancer tissues and associated with the development and progression of colorectal cancer. The joint detection of them may provide a new approach for the clinical diagnosis， treatment and prognostic evaluation of colorectal cancer.

Objective   To investigate the effect of rs10013228 polymorphism of vascular endothelial growth factor receptor 2 （VEGFR2） gene on the prognosis of patients with colorectal cancer after R0 resection. Methods   From January 2010 to December 2015， 154 cases of peripheral blood samples and 93 cases of postoperative cancer tissue specimens were collected from 154 patients with colorectal cancer who underwent R0 resection. Genotyping of VEGFR2 gene rs10013228 locus was performed by Tagman probe PCR genotyping. Real-time quantitative PCR （QPCR） was used to detect the level of VEGFR2 mRNA in tissues. The relationships between the distribution of rs10013228 genotype and clinicopathological parameters （age， sex， tumor location， differentiation， pathological stage and adjuvant chemotherapy） as well as the level of VEGFR2 mRNA were analyzed. The prognosis of different genotypes of rs10013228 was analyzed according to the follow-up data， and the multifactor analysis was carried out by the Cox risk proportion model. Results   Among all 154 patients， there were 95 cases of rs10013228 AA gene type（61.69％）， 51 cases of AG gene type（33.12％） and 8 cases of GG gene type （5.19％） with the minimum allele frequency of 0.22. The distribution of different genotypes was not related to age， sex， tumor location， differentiation， pathological stage and adjuvant chemotherapy （P＞0.05）. The median survival time （OS） of 154 colorectal cancer patients was 4.90 years. Single factor analysis showed that sex and tumor site were not related to OS， but age， degree of differentiation， pathological stage， adjuvant chemotherapy and rs10013228 gene type were related to OS. The median OS of rs10013228 AG/GG gene type was 5.60 years， longer than that of AA type （P＜0.05）. Multivariate analysis showed that age， pathological stage and rs10013228 were independent prognostic factors for colorectal cancer patients. QPCR detection showed that VEGFR2 mRNA level of AA type was higher than that of AG/GG （4.26±1.21 vs. 2.94±0.88）， and the difference was statistically significant （P＜0.05）. Conclusion  The VEGFR2 rs10013228 in colorectal cancer patients is related to the expression of VEGFR2 and the prognosis. Patients carrying the mutant allele of VEGFR2 present a lower expression of VEGFR2 and a better prognosis. It may affect the prognosis by influencing the expression of VEGFR2.

Objective   To investigate the expression of microRNA-30c （miR-30c） in renal cell carcinoma and its relationship with clinicopathological features and prognosis. Methods Ninety-five cases of surgical removed renal cell carcinoma tissues and 82 cases of paracancerous tissues from January 2012 to December 2015 were collected. Real-time quantitative PCR （QPCR） was used to detect the level of miR-30c in the above tissues. The relationship between miR-30c expression and clinicopathological parameters （gender， age， TNM stage， lymph node metastasis， distant metastasis and T staging） and prognosis of renal cell carcinoma were analyzed. Cox regression model was used for multivariate analysis. Results QPCR detection showed that the expression level of miR-30c in 95 cases of renal cell carcinoma was 0.561±0.378， lower than 1.220±0.820 in 82 cases of adjacent tissues （P＜0.001）. The expression of miR-30 in renal cell carcinoma was not related to sex， age and distant metastasis （P＞0.05）， but related to TNM stage， lymph node metastasis and T stage （P＜0.05）. The relative expressions of miR-30c in Ⅲ-Ⅳ stage， lymph node metastasis and T3-T4 stage were 0.422±0.219， 0.442±0.299 and 0.408±0.194， lower than 0.671±0.439， 0.619±0.400 and 0.654±0.431 in Ⅰ-Ⅱ stage， no lymph node metastasis and T1-T2 stage （P＜0.05）. The high expression rates of miR-30c in Ⅲ-Ⅳ stage， lymph node metastasis and T3-T4 stage were 21.43％（9／42）， 16.13％（5／31） and 19.44％（7／36）， lower than 41.51％（22／53）， 16.13％（26／64） and 40.68％（24／59） of Ⅰ-Ⅱ stage， no lymph node metastasis and T1-T2 stage （P＜0.05）. The median overall survival of miR-30c expression in the low level group was 37.0 months， which was significantly shorter than that in the high level group （＞60.0 months）， and the difference was statistically significant （P＜0.05）. Cox regression analysis showed that TNM stage， lymph node metastasis， distant metastasis， T stage and miR-30c expression were independent prognostic factors of renal cell carcinoma. Conclusion The low expression of miR-30c in renal carcinoma is involved in the development of renal cancer and is related to the prognosis. The prognosis of low expression of miR-30c is poor， and the level of miR-30c is an independent factor affecting the prognosis.

Objective  To explore the expression of Klotho gene in human laryngeal carcinoma tissues and its clinical significance. Methods The expression of Klotho mRNA and protein were measured in 80 paired normal and laryngeal squamous cell carcinoma （LSCC） tissue samples by real-time fluoresence quntitative polymerase chain reaction（QPCR） and Western blotting. The relation between Klotho expression and clinical pathological parameters was investigated. Methylation-specific polymerase（MSP） chain reaction were performed to analyze the DNA methylation of Klotho promoter. Results The expression of Klotho mRNA in LSCC tissues was 0.2890±0.012， significantly lower than 0.7908±0.015 in corresponding non-malignant tissues（P＜0.01）. The expression of Klotho protein in LSCC tissues was 0.2290±0.009， significantly lower than 0.5368±0.023 in their corresponding non-tumor tissues（P＜0.01）. The expression of Klotho was related to depth of tumor invasion and lymph node metastasis， but not related to age， sex， tumor location and degree of differentiation （P＞0.05）. The DNA methylation rate of Klotho gene promoter region in 80 cases of LSCC and adjacent non-tumor laryngeal tissues was 53.8％ （43／80） and 26.2％ （21／80）， respectively， and the difference was statistically significant （P＜0.05）. Conclusion  The aberrant DNA methylation of Klotho promoter region may be mainly responsible for its down-regulation in LSCC， and plays a key role in invasion and metastasis.

Objective  To investigate the application of antiemetic drugs in cancer patients during chemotherapy， so as to provide reference for rational drug use. Methods Clinical data of 533 tumor patients receiving chemotherapy in changhai hospital from June 2016 to May 2017 were retrospectively analyzed， and variables including age， primary tumor diagnosis， chemotherapy regimen and its emetogenic risk， adherence to guidline were collected. In this study， a descriptive statistical analysis was applied on the data of patients receiving single day or multiday chemotherapy regimen， according to NCCN antiemesis guideline. Results  In 533 patients receiving chemotherapy， the proportion of 5-HT3 antagonist preventive antiemetic therapy was 100％. Among them， the guidelines for high risk of vomiting were in accordance with the rate of chemotherapy. The daily chemotherapy was higher than that of the single day chemotherapy， which was 22.29％ and 15.79％ respectively. Conclusion  The prophylactic use of antiemetic drugs in cancer patients is based on 5-HT3 receptor antagonist combined with hormone， and the low compliance rate of antiemetic drug use is associated with the accessibility of aprepitant.

Objective To investigate the diagnostic value of acoustic radiation force impulse imaging（ARFI） in differentiating solid malignant and benign thyroid nodules. Methods A total of 68 patients（99 nodules） who underwent thyroid nodule resection were selected from June 2015 to September 2016 in the First Affiliated Hospital of Henan University of Science and Technology. All these imaging data were analyzed retrospectively. ARFI were performed in all patients before operation， and the shear wave velocity （SWV） of ARFI were observed and recorded. Pathological examination was considered as gold standard， the differences between benign and malignant nodules and the surrounding normal thyroid tissue were analyzed using the independent sample t test. The cut-off point of the SWV value of thyroid benign nodules was obtained by using the receiver operating characteristic curve （ROC）. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of ARFI technique in the diagnosis of benign and malignant nodular thyroid lesions were analyzed. Results The SWV of benign nodules， malignant nodules and the surrounding normal thyroid tissue were （2.68±0.51）m／s， （3.09±0.53）m／s and （2.42±0.22）m／s. The SWV of malignant nodules were higher than the benign thyroid nodules，and the SWV of benign and malignant nodules were higher than the surrounding normal thyroid tissue， the above differences were statistically significant（P＜0.001）. The SWV ratio of malignant nodule and surrounding normal thyroid tissues were 1.277±0.258， higher than 1.108±0.205 of benign nodule and surrounding normal thyroid tissues， and the difference was statistically significant（P＜0.001）. The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of SWV value and SWV ratio in the diagnosis of thyroid lesions were 63.41％， 74.14％， 69.70％， 63.41％， 74.14％ and 58.54％， 79.31％， 69.70％， 64.86％，72.58％ respectively. Conclusion As a noninvasive technique，ARFI is of high value in differenting benign and malignant thyroid nodules. It can be widely used in clinical diagnosis.

Objective To investigate the effect of different working experience of radiation therapist on intensity modulated radiation therapy in elderly patients with stage Ⅲ non-small cell lung cancer（NSCLC）. Methods A total of 160 elderly patients with stage Ⅲ NSCLC from August 2015 to August 2017 were enrolled. Depending on the working years of radiation therapist， all patients were randomly divided into ＜5 years group（n=80） and ≥5 years group（n=80）. All patients received concurrent chemoradiotherapy. The radiation dose was 60-70 Gy／30-35 f， 5 fractions per week. The drugs of chemotherapy included paclitaxel， docetaxel， pemetrexed， gemcitabine， cisplatin and carboplatin， et al. Results In ＜5 years group， there were 8 cases（10.0％） of complete remission（CR）， 48 cases of partial remission（PR）， 16 cases（20.0％） of stable disease（SD） and 8 cases（10.0％） of progression（PD）.The response rate（RR） was 70.0％. In ≥5 years group， there were 8 cases（10.0％） of CR， 68 cases（85.0％） of PR and 4 cases（5.0％） of PD. The RR was 95.0％. The difference of RR between the two groups had statistical significance（P＜0.05）. The stable and improve rate of quality of life was 80.0％ in ＜5 years group， lower than 92.5％ of ≥5 years group with statistical difference（P＜0.05）. Compared with ＜5 years group， the side effects in ≥5 years group were mild， but 3-4 grade of leucopenia and acute or long-term radio pneumonia between the two groups had no statistical differences（P＞0.05）. Conclusion The patients with stage Ⅲ NSCLC who received operation of radiation therapist with≥5 working years had better short-term effect and quality of life.

Objective To investigate the efficacy and safety of apatinib mesylate on advanced colon cancer failed in multi-line treatment. Methods From June 2016 to December 2017， 31 cases of advanced colon cancer failed in multi-line treatment received apatinib mesylate monotherapy （n=7） or in combination with chemotherapy （n=24） were enrolled in this study. The initial dose of apatinib was 425 mg／d. Chemotherapy drugs included S-1， oxaliplatin and irinotecan. Clinical efficacy and side effect were evaluated by RECIST1.1 criteria and NCI CTC 3.0 criteria， respectively. Progression-free survival （PFS） was also observed. Results After 4 weeks of apatinib treatment， among the 31 patients could be evaluated， partial remission （PR） was found in 5 cases， stable disease （SD） in 18 cases， and progression disease （PD） in 8 cases. The response rate was 16.1％ （5／31）， and disease control rate was 74.2％ （23／31）. After 8 weeks of apatinib treatment， among the 30 patients could be evaluated， PR was found in 3 cases， SD in 18 cases， and PD in 9 cases. The RR was 10.0％ （3／30）， and DCR was 70.0％ （21／30）. The short-term efficacy between those received apatinib monotherapy or in combination with chemotherapy had no differences （P＞0.05）. The median PFS of 31 patients was 3.5 months. There was no significant difference in PFS between different sex， age， primary site of tumor， metastatic site of tumor and whether in combination with chemotherapy （P＞0.05）. The main adverse reactions were hypertension， proteinuria， hand-foot syndrome， abnormal liver function， hematological toxicity and fatigue， mainly in grade 1-2. The incidence of hypertension and proteinuria （both 16.1％） was higher than other adverse reactions. Conclusion Apatinib mesylate for patients of advanced colon cancer failed in multi-line treatment is effective， and the adverse reactions are tolerable， which can be regarded as a choice for advanced colon cancer failed in multi-line treatment.

Colorectal cancer has the characteristics of high incidence and high mortality. Chemotherapy is one of the conventional treatment methods. The production of tumor resistance is the main reason for the failure of chemotherapy. Long chain non coding RNA （lncRNA） is involved in many physiological and pathological processes， and plays an important role in tumor proliferation， apoptosis， drug resistance and metastasis. Therefore， it is of practical significance to study the role of lncRNA in the drug resistance of colorectal cancer. In this review， we reviewed the progression of lncRNA in drug resistance mechanism of colorectal cancer at home and abroad.

Synchronous metastasis of rectal cancer accounts for 16%-20% of newly diagnosed rectal cancer. Of these patients with lower tumor burden received simultaneous or staged radical resection in both primary and metastases tumor could prolong overall survival. For these patients， pre-or post-operative pelvic radiotherapy improved locoregional control and the 2-year local recurrent rate was only 0-11％， but the majority （56％-75％） of recurrences occurred in distant organs， and radiotherapy did not improve 2-year overall survival rate of 65％-80％. For the patients with high tumor burden， the primary and metastases tumor could not be removed through surgical resection or local-directed therapy including radiofrequency ablation or transarterial chemoembolization. Of these patients， palliative radiotherapy could relieve symptomatic respose rate （bleeding， pain or obstruction） in 80％-85％ patients and last for a long term avoiding unnecessary colostomy. Short course radiotherapy of 5×5 Gy， which had advantages including short treatment time， lower toxicities， similar efficacy as long course radiotherapy and without delay of surgery or systemic chemotherapy should be the optimal radiation method for patients with synchronous metastases rectal cancer.

Gastrointestinal cancer is the most common malignant tumor with high morbidity and high mortality. Recently， the role of Neuropilin-1 in the development of digestive tract malignant tumor has become a hot spot. It can regulate the angiogenesis process of malignant tumor， mediate the proliferation and invasion of tumor cells， and thus promote the progression and metastasis of tumor. This article reviews its role in tumor angiogenesis， tumor proliferation and invasion， metastasis and tumor therapeutic targets.

The soaring cost of new antitumor drugs has prompted calls for more attention to the value of these products. In response to rapidly increasing health care spending， several organizations such as ASCO, ESMO, ICER, NCCN and DrugAbacus have developed frameworks to systematically assess the value of new drugs. Value assessment frameworks vary in their definition of components of value and their approach to assessment. This review analyzes and discusses several assessment frameworks in foreign countries by reviewing and synthesizing relevant literature， in order to help us build a framework for the evaluation of the value of antitumor drugs applicable to our country and carry out value-based treatment decisions.