ObjectiveTo investigate the expression of MKP3 in glioblastoma （GBM） and the effect of MKP3 overexpression on GBM cell proliferation and its possible molecular mechanism. 
MethodsTCGA database was used to analyze the expression of MKP3 in GBM and the survival of patients with different MKP3 expression. U87 MG cells was transfected with siMKP3 and siNC. The proliferation of glioblastoma U87 MG cell line was detected by MTT assay and EdU flow cytometry. Western blotting was used to detect the protein expression of pAKT， AKT， MKP3 and GAPDH. The role of PI3K／AKTMKP3 axis in the proliferation of glioblastoma was determined by a 1 μmol／L PI3K specific inhibitor and a pCDHMKP3 overexpression plasmid. 
ResultsThe analysis of TCGA database showed that the expression of MKP3 in GBM was significantly higher than that of normal tissue， and the difference was statistically significant （P＜005）； and the survival rate of patients with MKP3 high expression was significantly lower than that of patients with MKP3 low expression， and the difference was statistically significant （P＜005）. The MTT assay showed that the cell proliferation activity of the MKP3 expression silencing group was （0431±0116） significantly lower than that of the NC group （0986 ± 0056）， and the difference was statistically significant （P＜005）. The results of EdU showed that silencing MKP3 expression significantly inhibited the proliferation of U87 MG cells. Inhibition of PI3K／AKT signaling pathway can significantly block the proliferation of U87 MG cells. After overexpressed MKP3， the proliferation ability of U87 MG cells basically recovered. Overexpression of MKP3 did not increase the phosphorylation of AKT. 
ConclusionPI3K／AKT signaling pathway can promote the proliferation of GBM cells and increase the development of glioblastoma by up regulating MKP3 expression.

ObjectiveTo investigate the effect of honokiol on the expression of tissue factor pathway inhibitor2（TFPI2） and the effect of overexpression of honokiol and TFPI2 on the apoptosis of human glioma U251 cells. 
MethodsThe U87， U251， LN18， LN229 and A172 cell lines of glioma were cultured in vitro， and the expression of TFPI2 in different cell lines was detected by fluorescence quantitative PCR （QPCR）. Honokiol treated U251 cells with different concentrations （0， 10， 20， 30， 40 and 50 μmol／L）. QPCR and Western blotting were used to detect the expression changes of TFPI2 mRNA and protein. The expression of TFPI2 in U251 cells was overexpressed by adenovirus vector pGSadenoTFPI2， and apoptosis rate and caspase3 activity were detected by flow cytometry and caspase3 kit. 
ResultsThe TFPI2 mRNA in U251 and A172 cells decreased significantly in U87， U251， LN18， LN229 and A172 cell lines （P＜005）. Honokiol increased TFPI2 mRNA level in U251 cells in a concentration dependent manner （P＜005）. After 50 μmol／L honokiol intervened for 24 h， the expression level of TFPI2 mRNA increased most significantly （P＜005）. The expression level of TFPI2 in U251 cells increased significantly after transfected with adenovirus vector pGSadenoTFPI2 （P＜005）. Overexpression of TFPI2 and 50 μmol／L honokiol could increase U251 cell apoptosis and caspase3 activity （P＜005）. 
ConclusionHonokiol can increase the expression of TFPI2 in U251 cells， and overexpressed TFPI2 combined with honokiol significantly induced apoptosis in glioma cells.

ObjectiveTo investigate the effect of microRNA933 （miR933） on the regulation of brainderived neurotrophic factor （BDNF） and the migration and invasion of hepatoma cells. 
MethodsThirty pairs of hepatoma and paracancerous tissues surgically removed in our hospital were collected from January 2017 to December 2017. Levels of miR933 in the above tissues and hepatoma cells （Huh7， HepG2 and SKHep1） were detected by realtime quantitative PCR （QPCR）. SKHep1 cells were transfected with miR933 mimic （overexpressing group） and negative control （control group） by liposome method. QPCR was used to detect the miR933 level of each group at 48 h after transfection to evaluate the transfection efficiency. The invasion and migration of each group were evaluated by Transwell and scratch test， respectively. QPCR and Western blotting were used to detect the mRNA and protein levels of BDNF in each group. The dual luciferase reporter gene assay was applied to confirm the target and binding sites between miR933 and BDNF. 
ResultsThe level of miR933 was 0351±0026 in hepatoma tissues， lower than 1124±0054 of normal paracancerous tissue （P＜005）. The levels of miR933 in Huh7， HepG2 and SKHep1 cells were 0751±0062， 0453±0057 and 0017±0006， lower than that of the healthy hepatocyte line L02 （P＜005）. The miR933 level of SKHep1 cells in overexpression group at 48 h after transfection was 3197±0354， higher than 1019±0079 of the control group （P＜005）. The rate of healing and the number of membrane cells in the overexpressed group were （244±39）％ and 576±68， lower than （625±47）％ and 1026±95 of the control group （P＜005）. The mRNA and protein levels of BDNF in the overexpression group were lower than those in the control group （P＜005）. The results of double fluorescence report showed that miR933 significantly inhibited the luciferase activity of cells transfected with the wild type BDNF3’UTR plasmid， but had no significant effect on cells transfected with mutant BDNF3’ UTR. 
ConclusionThe levels of miR933 in the tissues and cells of liver cancer were reduced， and the invasion and migration of hepatoma cells could be inhibited. It may be realized by targeting BDNF， which can be used as a potential target for the treatment of liver cancer.

ObjectiveTo investigate the role and possible molecular mechanism of miRNA26b （miR26b） in the regulation of autophagy in hepatocellular carcinoma cells. 
MethodsThe expression of miRNA26b in human normal liver cell line HL7702 and human hepatoma cell lines HepG2， Hep3B， Bel7402 and SSMC7721 was detected by fluorescence quantitative PCR （QPCR）. Dual luciferase reporter assay was used to evaluate the regulatory effect of miR26b on IL6. MiR26b mimics （transfected group） and negative control NC （negative control group） were transfected into HepG2 cells， and Western blotting was used to detect the expression of IL6／STAT3 signaling pathway and autophagy related protein in two groups. IL6 siRNA1 and IL6 siRNA2 were transfected into HepG2 cells and Western blotting was used to detect STAT3 activation and autophagy related protein expression after interfering IL6. 
ResultsThe expression levels of miR26b in HepG2， Hep3B and Bel7402 cell lines were 034±0063， 069±0092， 057±0086， which was significantly lower than that of normal liver cell line HL7702 （115±0189）， and the difference was statistically significant （P＜005）. MiR26b inhibited the luciferase activity of wildtype IL6 3’UTR reporter gene vector， but had no effect on the luciferase activity of mutant IL6 3’ UTRMUT. After transfection of miR26b mimics， the relative expression of IL6 and pSTAT3 decreased significantly （P＜005）， and the relative expression of autophagy related protein Beclin1 and the ratio of LC3 II／LC3 I increased significantly （P＜005）. After the silence IL6 expression， the relative expression of pSTAT3 decreased significantly （P＜005）， and the relative expression of autophagy related protein Beclin1 and the ratio of LC3 II／LC3 I increased significantly （P＜005）. 
ConclusionMiRNA26b can inhibit the activation of IL6／STAT3 signaling pathway and induce autophagy in hepatoma cells.

ObjectiveTo investigate the relationship between miR21 expression and sensitivity of gastric cancer cells to apatinib and its possible mechanism. 
MethodsAGS cells and drugresistant AGSAR cells were cultured in vitro and transfected with miR21 inhibitor or miR21 mimics respectively. QPCR was used to detect the expression level of miR21 in AGS and AGSAR cells. QPCR was used to detect the effects of apatinib on the expression of pVEGFR2 and pAkt mRNA in AGS and AGSAR cells with different concentrations （0， 2， 5， 10 μmol／L）， as well as the effects of different miR21 expressions on the pVEGFR2， pAkt and pAkt expression levels of AGS and AGSAR cells. The effects of apatinib on proliferation and migration of AGS and AGSAR cells were detected by MTT and scratch test. 
ResultsThe expression of miR21， pVEGFR2 and pAkt in AGS cells were 082±009， 073±009 and 068±008 respectively， which were higher than 035±010， 033±007 and 025±004 of AGSAR， and the difference was statistically significant （P＜005）. After the treatment of apatinib， the proliferation and migration activity of AGSAR cells was significantly higher than that of AGS cells （P＜005）. After 10 μmol／L apatinib treatment for 24 h， the survival rate and migration distance of AGS cells in negative control group were （3948±745）％ and （7044±1157） μm respectively， significantly lower than that of miR21 inhibitor transfected AGS cells [（8063±827）％ and （10846±1039） μm]， and the difference was statistically significant （P＜005）. The survival rate and migration distance of AGSAR cells in negative control group （7882±814）％ and （9315±986） μm were significantly higher than （2995±674）％ and （6143±985） μm of AGSAR cells transfected by miR21 mimics， and the difference was statistically significant （P＜005）. After transfection of miR21 inhibitor， the relative expression levels of pVEGFR2 and pAkt mRNA in AGS cells were 112±013 and 082±010 respectively， which were significantly higher than 073±011 and 064±011 in the negative control group， while the expression level of PTEN mRNA was down （018±004 vs. 051±008）， and the differences were statistically significant （P＜005）. After transfection of miR21 mimics， the relative expression levels of pVEGFR2 and pAkt mRNA in AGSAR cells were 017±004 and 012±003 respectively， which were significantly lower than 030±004 and 025±002 in the negative control group， while the expression level of PTEN mRNA was up （053±006 vs. 044±003）， and the difference was statistically significant （P＜005）. 
ConclusionUp regulation of miR21 expression can increase the phosphorylation level of VEGFR2 and Akt， thereby enhancing the sensitivity of gastric cancer cells to apatinib.

ObjectiveTo discuss the effect and mechanism of miR375 on imatinib sensitivity in GISTT1 gastrointestinal stromal tumor （GIST） cell. 
MethodsFrom January 2017 to February 2018， 45 specimens of gastrointestinal stromal tumors and corresponding normal gastric mucosa specimens were collected from the pathology department of Henan Cancer Hospital. GISTT1 cells were transfected into miR375 mimics （transfection group） or empty plasmid （negative control group） respectively. The proliferation and apoptosis activity of the two groups were detected by MTT and flow cytometry. Fluorescence quantitative PCR （QPCR） was used to detect the level of miR375 in the gastrointestinal stromal tumors and the expression levels of miR375， pVEGFR2， pAkt and PTEN in GISTT1 cells. 
ResultsThe levels of miR375 in the gastrointestinal stromal tumor tissues and the normal mucosa adjacent to the carcinoma were 0673±0078 and 1000±0101 respectively， and the difference was statistically significant （P＜005）. The expression of miR375 was positive in 13 cases of gastrointestinal stromal tumors， and the positive expression rate was 289％. After treatment with different concentrations of imatinib （2， 5， 10 μmol／L）， the proliferation inhibition rate and apoptosis rate of the transfected group were（2451±210）％，（5239±423）％，（8457±464）％ and （1795±366）％，（3542±357）％，（6347±324）％，compared with the negative control group， the difference was statistically significant （P＜00 5）. After treated with 613 μmol／L imatinib， the expression of miR375 in GISTT1 cells was 2439±0056， which was significantly higher than that of untreated imatinib （1000±0037）， and the difference was statistically significant （P＜005）. After transfection of miR375 mimics， the expression level of pVEGFR2 and pAkt in GISTT1 cells was 212±007 and 182±009 respectively， which was significantly higher than that of the negative control group， and the expression level of PTEN mRNA was 045±012， significantly lower than that of the negative control group， the difference was statistically significant （P＜005）.The miR375 expressions of GISTT1 cells were positively correlated with pVEGFR2 and pAkt mRNA expressions （r=0689，0465， P＜005） and negatively correlated with PTEN mRNA （r=-0523， P＜005）. 
ConclusionThere are significant evidences that upregulation miR375 could enhance the sensitivity of gastrointestinal stromal tumor cell to imatinib.

ObjectiveTo explore the changes in the efficacy and adverse events of docetaxel （DTX） after adjusting dose according to the plasma concentration in advanced nonsmall cell lung cancer（NSCLC）. 
MethodsA total of 100 advanced NSCLC patients from October 2015 to April 2017 were enrolled and given DTX+carboplatin regimen as the firstline chemotherapy. The dose of DTX for the first cycle was 75 mg／m2， and then patients were divided into conventional group and experimental group according to area under the plasma drug concentrationstime curve （AUC） and the degree of myelosuppression. Patients of AUC ranging from 25 to 37 mg·h／L were assigned into conventional group， and patients of AUC ＜25 or ＞37 mg·h／L and myelosuppression were assigned to experimental group. The DTX dose in conventional group was given at 75 mg／m2 in subsequent cycles. And the dose in experimental group was adjusted according to the AUC and the degree of myelosuppression in the previous cycle. 
ResultsIn conventional group， there were 16 cases in PR， 21 cases in SD， and 13 cases in PD. The response rate （RR） was 320％， the disease control rate was 740％， and the median progressionfree survival（PFS） was 55 months. In experimental group， there were 19 cases in PR， 18 cases in SD， and 13 cases in PD. The RR and DCR were 380％ and 740％， and the median PFS was 58 months. The differences of RR， DCR and median PFS between the two groups had no differences （P＞005）. The average AUC ranged 3133（mg·h／L） in conventional group. The dose of DTX was reduced by 25％ due to myelosuppression in 2 patients at the fourth cycle. In experimental group， 35 patients had 15％ DTX dose reduction， 8 patients had 20％ reduction and 7 patients had 30％ reduction at the second cycle； 5 patients had 15％ reduction and 1 patient had 25％ reduction at the third cycle. With the adjustment of DTX， the average of AUC decreased. The average AUC at the fourth cycle was 30， lower than 33 of conventional group （P＜005）. The occurrence of myelosuppression in conventional group rose with the increase of chemotherapy cycles， while that in experimental group decreased with the increase of chemotherapy cycles and decrease of AUC. The occurrence of myelosuppression in experimental group was 162％， much lower than 649％ of conventional group （P＜0001）. 
ConclusionBy adjusting the DTX dose based on plasma concentration for NSCLC， the efficacy is equal to conventional treatment with less adverse events， which is worthy of clinical application.

ObjectiveTo compare the differences in clinicopathological characteristics and prognosis between gastric cancer with and without neuroendocrine differentiation （NED）. 
MethodsFrom January 2010 to August 2017， 98 gastric cancer with NED and 338 gastric cancer without NED patients with data of clinicopathological characteristics from Nanjing Drum Tower Hospital were collected. The clinicopathological characteristics between the two groups of patients were compared by chisquare test. Survival rate was calculated by KaplanMeier curve， univariate and multivariate prognostic risk factors were analyzed by Logrank test and Cox regression model. 
ResultsThe two groups of gastric cancer patients with and without NED had the following common characteristics： similar onset symptoms， more younger than 65 years old， more bigger than or equal to 4 cm tumor size， high proportion of nerve invasion， and the rates of lymph node and distant metastasis were similar. However， there were some significant diferences in gender， histological types， T stage， tumor TNM stage and vascular invasion between this two groups （P＜005）. The positive expression rates of CgA and Syn were 704％ and 755％， both expression rate was 459％. The 1， 3 and 5 years survival rates in gastric cancer patients with NED were 735％， 462％ and 342％， lower than 889％， 641％ and 537％ in those without NED， and the differences were significant （P＜005）. Univariate analysis showed that age， tumor size， differentiation， TNM stage， vascular and nerve invasion were associated with prognosis of gastric cancer with NED （P＜005）. Multivariate analysis showed that age was an independent factor affecting the prognosis （P＜005）. 
ConclusionImmunohistochemistry is the main method to diagnose gastric cancer with NED. Gastric cancer patients with NED may have poor prognosis.

【Key Words】Gastric cancer；Neuroendocrine differentiation；Prognosis；Chromogranin A；Synaptophysin

ObjectiveTo investigate the clinical significance of serum albumin （ALB） and prealbumin （PA） in the shortterm efficacy of hodgkins lymphoma （HL）. 
MethodsThe clinical data of 103 patients with HL who were diagnosed as initial diagnosis at 307 Hospital from January 2010 to July 2016 were collected and analyzed retrospectively. Based on the ALB and PA levels before treatment， the shortterm efficacy of HL was analyzed. 
ResultsAmong the 103 patients with HL， complete remission（CR） was achieved in 60 cases（583％）， partial remission（PR） in 37 cases （359％）， and the total effective rate was 942％. Among the patients with ALB＜35 g／L， 7 cases （200％） achieved CR. Among the patients with ALB≥35 g／L， 53 cases （779％） achieved CR. Among the patients with PA＜200 mg／L， 23 cases （383％） achieved CR. Among the patients with PA≥200 mg／L， 37cases （860％） achieved CR. Compared with ALB＜35 g／L group， the patients with ALB＜35 g／L often had B symptoms， advanced stage， extranodal involvement， high IPS score and low CR rate （P＜005）. Compared with PA≥200 mg／L group， the patients with PA＜200 mg／L often accompanied by B symptoms， extranodal involvement， high IPS score， lymph nodal sites≥3 and low CR rate （P＜005）. Multivariate analysis showed that ALB alone was an independent factor for CR in HL. 
ConclusionPretreatment ALB and PA are associated with CR of HL， and have a significant effect on the short term efficacy of HL.

ObjectiveTo explore the efficacy of octreotide acetate （OA） injection in the enhancement of colorectal cancer（CRC） patients recovery following laparoscopic surgery. 
MethodsFrom October 2014 to September 2016， CRC patients who underwent laparoscopic surgery and did not indwell nasogastric tubes after surgery were divided into 2 groups： OA group （103 patients）， who received routine therapy plus OA injection at a dose of 02 mg ih q8h for 3 days and control group （51 patients） subjected only to routine therapy. Patients of the two groups were observed for nasopharynx discomfort， abdominal distention， nausea， vomiting， intestinal obstruction， pulmonary infection， anastomotic leakage， rein dwelling nasogastric tubes， the first passage of flatus and hospital stay. 
ResultsFive patients suffered from postoperative abdominal distention in the OA group， less than 9 patients in the control group （P＜005）. Eight patients suffered from postoperative nausea and vomiting in the OA group， less than 10 patients in the control group（P＜005）. Five patients suffered from postoperative nasopharynx discomfort in the OA group，similar with 3 patients in the control group（P＞005）. Three patients in the OA group and 3 patients in the control group reined dwelling nasogastric tubes because of intestinal obstruction or severe nausea and vomiting， and there was no statistic difference significantly between two groups（P＞005）. In addition， postoperative intestinal obstruction， pulmonary infection， anastomotic leakage， the first passage of flatus and hospital stay remained unchanged between the two groups （P＞005）. 
ConclusionOA injection can effectively reduce abdominal distention and nausea and vomiting after laparoscopic CRC surgery, and can be used safely after operation.

ObjectiveTo explore the effectiveness and safety of the application of the concept of enhenced recovery after surgery （ERAS） in laparoscopic radical cystectomy. 
MethodsFiftyeight patients with bladder cancer admitted in Weifang Peoples Hospital from June 2015 to June 2017 were divided into the traditional group （n=28） and the ERAS group （n=30）. The time of operation， the amount of bleeding， the time of postoperative exhaust， the number of postoperative severe pain， the time of anaesthesia， the time of pelvic drainage， the number of days after the operation and the incidence of postoperative complications were compared in the two groups. 
ResultsThe operation time of the ERAS group and the traditional group were （1722±379） min and （1873±218） min， respectively； and the intraoperative bleeding volume was （1597±465） ml and （1771±469） ml respectively； the difference was not statistically significant （P＞005）. The anesthesia recovery time of group ERAS and the traditional group were （254±54） min and （417±98） min； the postoperative exhaust time was （16±07） d and （22±07） d； the pelvic drainage time was （25±11） d and （5±16） d； the postoperative hospitalization day score ratio was （76±14） d and （110±18）d， and postoperative pain VAS score The incidence of ＞7 was 10％ （3／30） and 429％ （12／28）； the difference between the two groups was statistically significant （P＜005）. In group ERAS， there were 1 case of knife liquefaction， 1 case of kidney stones； in the traditional group， there were 2 cases of intestinal obstruction， 1 case of hyper accumulating pneumonia， and 1 case of kidney stones. There were no patients with fistula in both two groups. 
ConclusionThe application of concept of enhenced recovery after surgery in laparoscopic radical cystectomy is safe and effective， and it can accelerate the postoperative rehabilitation of the patients. It is worthy of clinical application.

ObjectiveTo investigate the effect of whole course nutritional support on acute radiation response， treatment tolerance and curative effect of cervical cancer patients. 
MethodsNinetyeight locally advanced cervical patients with radical concurrent chemoradiotherapy and nutritional risk screening2002 scoring more than 3 points were divided randomly into two groups： 46 cases in the experimental group （used whole course nutritional support combined concurrent chemoradiotherapy） and 52 cases in the control group （only concurrent chemoradiotherapy）. The body mass index （BMI）， albumin （ALB）， prealbumin （PA） and quality of life score （KPS score） were recorded before and after radiotherapy， and the acute radioactivity， treatment tolerance （the total course of radiotherapy， the interruption rate of radiotherapy， the number of chemotherapy） and the curative effect were evaluated at the end of the radiotherapy. 
ResultsIn the experimental group， the treatment was completed according to the plan， only 13 cases had been interrupted by radiotherapy， and 45 of the 52 cases in the control group had been treated with radiotherapy interruption， of which 9 cases failed to complete the radiotherapy according to the plan. The rate of radiotherapy in the experimental group was lower than that of the control group （2826％ vs. 8654％）， and the number of chemotherapy in the experimental group was more than that of the control group （496 ± 021 vs. 431 ± 073）. The total day of radiotherapy in the experimental group was lower than that of the control group （6313 ± 647 vs. 8523 ± 1928）， and the difference was statistically significant （P＜005）. The ALB and PA of the experimental group were better than those of the control group after radiotherapy （P＜005）. The incidence and incidence of acute radiation proctitis， acute gastrointestinal reaction and myelosuppression in the experimental group were lower than those in the control group （P＜005）. The total effective rate （RR） of the experimental group was significantly higher than that of the control group （9348％ vs. 7442％）， and the difference was statistically significant （P＜005）. 
ConclusionTotal nutritional support can significantly reduce the acute radiation reaction in patients with radical cervical cancer， improve the patients nutritional status and quality of life， and improve the therapeutic tolerance and radiotherapy effect.

ObjectiveTo investigate the adverse reactions and the efficacy of adriamycin+cyclophosphamide+docetaxel （ACT） sequential chemotherapy and docetaxel+adriamycin+cyclophosphamide （TAC） combined chemotherapy in postoperative treatment of breast cancer. 
MethodsFrom February 2012 to September 2013， 130 postoperative breast cancer patients were randomly divided into observation group and control group with 65 cases in each group. Control group was treated with TAC combined chemotherapy： cyclophosphamide iv 500 mg／m2d1， adriamycin iv 50 mg／m2 d1， docetaxel 100 mg／m2 iv d1. Twentyone days was a cycle and 6 cycles was given. Observation group was given ACT sequential chemotherapy： cyclophosphamide 500 mg／m2 iv d1， adriamycin 50 mg／m2 iv d1. Twentyone days was a cycle and 4 cycles was given. And then docetaxel 100 mg／m2 iv d1was given with 21days as a cycle for 4 cycles. Adverse reactions and lymph node metastasis were recorded， and the dieasefree survival time（DFS） of the two groups was followed up. The level of serum angiopoietin 2 （ANG2）， vascular endothelial growth factor （VEGF） and nm23H1 protein were tested. 
ResultsAfter treatment， the levels of ANG2 and VEGF in observation group were significantly lower than those in control group［（341±39） ng／L vs. （581±36） ng／L； （518±43） ng／L vs. （817±44） ng／L］， while the level of nm23H1 protein was significantly higher than that in control group［（669±42） ng／m vs. （533±33） ng／ml］. The differences had statistical significance between the two groups （P＜005）. The main adverse reactions were in grade 12. The incidence of leukopenia， neutropenia， nausea， vomiting， oral mucositis and hepatic dysfunction in observation group were lower than those in control group （P＜005）. The number of lymph node metastasis in observation group was significantly lower than that in control group （P＜005）. The occurrence time of lymph node metastasis in observation group was longer than that in control group （P＜005）. The median DFS was 424 months in observation group， longer than 346 months in control group （P＜005）. 
ConclusionThe long term efficacy of ACT sequential chemotherapy is superior to TAC combined chemotherapy for postoperative breast cancer patients， which shows fewer adverse reactions and can effectively inhibit the lymph node metastasis of breast cancer. therefore it is worthy of clinical promotion.

ObjectiveTo investigate the effect of radiotherapy target area delineation on efficacy and toxicity in locally advanced small cell lung cancer. 
MethodsFrom October 2012 to October 2014， 128 patients with locally advanced small cell lung cancer were randomly divided into control group（n=64） and observation group（n=64）. The target areas were identified by enhanced CT localization and scanning. The two groups of PTVT were all expanded after chemotherapy. In the control group， PTVN was defined as a positive lymph node drainage area extending outward. The PTVN in the observation group was the lateral spread error of GTVN. PTVT and PTVN prescription dose was 60 Gy／30 fraction， 2 Gy／f， 5 fractions per week. The mean lung dose （MLD）， double lung V20 and curative effect were compared between the two groups， and the recurrence and toxic reaction of the patients in 3 years were followed up. 
ResultsThe observation group MLD and V20 of double lung were （955±228） Gy and （2165±376）％， lower than the control group （1275±243） Gy and （2532±423）％， the difference was statistically significant （P＜005）. The remission rate（RR） in the observation group was 672％ （43／64）， while that in the control group was 719 （46／64）. There was no significant difference between the two groups （P＞005）. The 3year recurrence rate of the two groups was 100％. In the control group， 45 cases recurred in the radiation field， and 19 cases recurred out of the radiation field. In the observation group， 48 cases recurred in the radiation field， and 16 cases recurred out of the radiation field. There was no significant difference between the two groups （P＞005）. The observation group of more than 3 hematological toxicity， acute radiationinduced pneumonia， weight loss rate was 47％， 266％ and 234％， were lower than the control group 188％， 547％ and 516％， the differences were statistically significant （P＜005）. 
ConclusionTarget delineation （PTVN） can effectively reduce MLD and V20 of double lung of locally advanced small cell lung cancer patients after chemotherapy， had no effect on the clinical efficacy and recurrence of the tumor， and can significantly reduce the adverse reaction.

Cancer cachexia is a cancerinduced multifactor complex syndrome. About 50％80％ of patients with advanced malignant tumors suffer from cancer cachexia， which counteracts effect of antitumor therapy， reduces the quality and duration of life. The mechanism of this metabolic disorder caused by tumors， is very complicated because of its serious influence on multiorgan. As a result， the evaluation and staging of its severity become difficult things. Furthermore， the intervention means to ameliorate cancer cachexia are limited at present while so much disagreement of views on treatment exists. The individualized， multidisciplinary， multimodal therapies are now advocated in clinical practice. In this paper， we shall review the progress in researches from the aspects of mechanism， evaluation and clinical medication of cancer cachexia.

Chimeric antigen receptor T cells （CART） therapy is a new method of tumor immunotherapy. The complete response rate of CART cell therapy for B cell acute lymphoblastic leukemia （BALL） is as high as 90％. However， there are some problems of CART cell therapy in the treatment of blood tumor， such as offtarget activity， toxic side effect， short duration of the body and high recurrence rate. In addition， the safety and efficacy of CART cells in the treatment of solid tumors have been confirmed， but the efficacy remains to be improved. In this paper， the research progression of CART cell therapy in recent years and the urgent problems in this field are analyzed and prospected.

About 10％15％ of breast cancer patients have brain metastases. The incidence of brain metastases will continue to increase with prolonged survival and the control of extracranial metastases. Currently， brain metastases are still important clinical challenges and associated with extremely poor prognosis. The molecular subtypes of breast cancer directly affect the incidence of brain metastases， treatment options and prognosis of patients. The current treatment strategies include local therapy and systemic therapy. This article reviews the relationship between the molecular subtypes of breast cancer and the incidence and molecular mechanism of brain metastases and the treatment methods， aiming to improve the new ideas for the individualized diagnosis and treatment of breast cancer patients with brain metastases and multidisciplinary management.

Human epidermal growth factor receptor 2 （HER2） is a transmembrane tyrosine kinase receptor which can activate the downstream signaling pathways， leading to proliferation and survival of cancer cells. HER2 positive breast cancer is a special subtype of breast cancer with high malignancy and poor prognosis. Trastuzumab， an antiHER2 monoclonal antibody， is able to improve the treatment efficacy of this kind of cancer， but could not escape the ending of resistance ultimately. In recent years， researches on mechanism of trastuzumab resistance， development of novel targeted drugs and exploration of the treatment strategies have made significant progress in overcoming the resistance of trastuzumab. This article is going to introduce strategies of targeted therapy and also the data of clinical trials focusing on the treatment against trastuzumab resistance.