Objective To analyze the median progression-free survival （mPFS）,median overall survival （mOS） time and safety of a multikinase inhibitor with transcatheter arterial chemoembolization （TACE） or programmed death protein-1 （PD-1） inhibitor in patients with Chinese liver cancer staging （CNLC） stage ⅡB～ⅢB hepatocellular carcinoma in Tibet.Method By searching the hepatocellular carcinoma patients hospitalized in the Oncology Department of the People’s Hospital of Tibet Autonomous Region from January 2018 to December 2021,they were confirmed as primary liver cancer by clinical or pathology,which were in line with CNLC stage Ⅱ B～Ⅲ B;according to the treatment plan,they were divided into multikinase inhibitor with TACE group （61 cases） and multikinase inhibitor with PD-1 inhibitor group （26 cases）;according to the imaging examination （CT or MRI） before and after treatment,and then refer to response evaluation criteria in solid tumors version 1.1 （RECIST 1.1） to evaluate the curative effect;the survival were recorded through follow-up,the relevant survival curves were drawn and subgroup analysis were carried out;the toxic and side effects of the two groups were understood through relevant laboratory and imaging examinations and follow-up,and the safety of the treatment schemes of the two groups were evaluated.Result As of December 31,2021,the mPFS time of the multikinase inhibitor with TACE group and the multikinase inhibitor with PD-1 inhibitor group were 8.1 months and 17.9 months,and the mOS time were 16.1 months and not reached the finish line,with significant statistical differences （all P＜0.05）.In subgroup analysis,there were statistically significant differences in mPFS time between the two groups in the subgroup of patients with male,age 60 years or more,always without liver cancer surgery,always with no history,Eastern Cooperative Oncology Group （ECOG） performance status （PS） 1～2 score,Child-Pugh grade A,α-fetoprotein≥200 ng/ml,and lenvatinib group （all P＜0.05）.In the subgroup analysis,there were statistically significant differences in mOS time between the two groups in the subgroup of patients with no previous TACE treatment history and no change in treatment regimen （all P＜0.05）.The number of stable disease cases,progressive disease cases and disease control rates in the multikinase inhibitor with PD-1 inhibitor group and the multikinase inhibitor with TACE group were 21 cases,5 cases,80.8% and 24 cases,36 cases,41.0%,respectively,the differences were statistically significant （all P＜0.05）.In the multikinase inhibitor with TACE group,the increase of AST,bilirubin,abdominal pain and fever were more common in the multikinase inhibitor with PD-1 inhibitor group （P＜0.05）,while abdominal distension was less common （P＜0.05）.Conclusion Compared with the group of the multikinase inhibitor with TACE group,the group of the multikinase inhibitor with PD-1 inhibitor have stronger antitumor effect.Compared with the multikinase inhibitor with TACE group,the treatment-related adverse reactions in the multikinase inhibitor with PD-1 inhibitor group are controllable and tolerable.

目的 研究西藏地区恶性黑色素瘤(Malignant melanoma,MM)的临床特征及转移因素的分析.方法 收集我院2011年1月～2021年3月恶性黑色素瘤80例的临床资料.观察临床特征及影响恶性黑色素瘤转移的高危因素.结果 ①临床特征:80例中,男性占45％,女性占55％;发病平均年龄57.91±12.746岁,48～68岁45例(56.25％);农牧民62例(77.5％);皮肤66例(82.5％),其中四肢49例(74.24％),躯干5例(7.58％),头颈12例(18.18％);黏膜14例(17.5％);术后转移29例(36.25％).②采用二元Logistic回归分析提示色素沉着、术后复发是MM转移的高危因素.结论 西藏地区MM好发于皮肤四肢,以农牧民居多;色素沉着及术后复发是其危险因素.

目的 对不同新辅助化疗方案针对三阴性乳腺癌患者进行治疗的效果进行调查.方法 回顾性分析我院50例不同方案治疗的三阴性乳腺癌患者,其中有16例患者采用多西他赛联合表阿霉素、环磷酰胺化疗,视为甲组;有17例患者采用多西他赛联合环磷酰胺化疗,视为乙组;其余17例患者采用表阿霉素联合氟尿嘧啶、环磷酰胺化疗,视为丙组,调查患者治疗效果.结果 甲组患者疗效评估有效率显著优于乙组和丙组,丙组患者优于乙组, P<0.05;三组患者不良反应发生率比较无统计学差异,P>0.05;甲组复发率显著优于乙组和丙组,丙组优于乙组, P<0.05.结论 多西他赛联合表阿霉素、环磷酰胺化疗效果更为理想.

The healthcare system (HCS) improved in Tibet Autonomous Region (TAR), China. The present study aimed to investigate whether these improvements might alter the clinicopathological characteristics of a Tibetan female with breast cancer (BC) in TAR. This was a single-center cross-sectional study conducted at TAR People’s Hospital. All Tibetan adult women were treated for BC in this hospital between January 1, 1973 and December 31, 2015. The inclusion criteria were as follows: (1) Tibetan adult woman living in Tibet; (2) Histopathology or cytopathology or both confirming primary BC; (3) All the treatments were finished in this hospital. χ2 test and logistic regression were applied, using age group and census register as the two covariates. A total of 273 patients with BC were included in the final analysis. Of these, 14 patients were in the free HCS, 183 patients had medical insurance combined with a new rural cooperative HCS, and 76 were in a rural and urban integration HCS. Currently, a rural and urban integration HCS is an improved system. Consequently, an increase in the proportion patients in the T1–3 stage was observed (0.198; 0.046 to 0.852) between the rural and urban integration HCS and free HCS. The proportion of patients in early (I + II) stage cancer (0.110; 0.019–0.633) also increased between these two HCSs. This was the first report about Tibetan women with BC in Tibet. Some clinicopathological characteristics at the presentation of Tibetan women with BC may improve during different HCSs. The cancer awareness, early detection, and the overall management in patients with advanced stage BC might improve the prognosis of BC in the rural and urban integration HCS.

目的 此次研究分析在原发性肝癌患者治疗中采用TACE(肝动脉化疗栓塞术)联合碘油吡柔比星乳剂5-fu的临床疗效以及对AFP水平与CA19-9水平影响.方法 本次研究将本院2014年1月～2018年6月原发性肝癌患者100例作为研究对象,随机将其分为联合组与单用组,单用组患者采用单纯TACE治疗,联合组采用TACE联合碘油吡柔比星乳剂5-fu治疗,对比其治疗效果.结果 对比两组患者总缓解率与各项治疗指标,并以此作为治疗质量的评判依据,通过本次研究结果数据分析得知,联合组患者总缓解率与各项指标均较为优异,且与对照组相比,差异有统计学意义(P<0.05).结论 在原发性肝癌患者治疗中采用TACE联合碘油吡柔比星乳剂5-fu,对患者临床疗效具有改善作用,还可以进一步提高治疗质量,为有效治疗方法.

[Purpose] To analyze the composition of patients with malignant tumors in a general hospital of Tibet.[Methods] The medical records of patients with malignant tumors admitted in the People's Hospital of Tibet Autonomous Region during September 2013 to August 2017 were collected.According to ICD-10,all cases were categorized and the proportion of cancers was analyzed by time,gender and age.[Results] Total 1929 cases with malignant tumor were admitted,the average age of patients was 53.78±13.01 years and the male to females ratio was 1.38∶1.The top five cancers were gastric cancer,liver cancer,breast cancer,esophageal cancer and colorectal cancer;gastric cancer,liver cancer,esophageal cancer,lung cancer and colorectal cancer for males and breast cancer,stomach cancer,liver cancer,esophageal cancer and colorectal cancer for females.The incidence peak was in the age group of 40～69,accounting for 75.80％.[Conclusion] The constitution of malignant diseases in Tibet region is different from other regions in China,so it is important to take cancer surveillance and prevention measures accordingly.

目的 了解西藏地区高原世居藏族原发性肝癌(primary liver cancer,PLC,以下简称PLC)的发病情况,并用医学统计学方法对其发病情况进行分析,为西藏卫生部门及肿瘤专业临床医生制定关于PLC针对西藏的一、二级预防措施提供参考.方法 通过对西藏自治区人民医院肿瘤科2012年9月至2016年9月同期入院并确诊为PLC的208例西藏高原世居藏族住院病例进行回顾性分析,计数资料组间比较应用X2检验.结果 208例病例中有男性159例(76.44％),女性49例(23.56％),男:女=3.16:1.年龄分布为46-65岁年龄段发病率最高(136例,65.4％),平均发病年龄54.69±0.79岁,其中男性为55.23±0.86岁,女性为52.96±1.88岁;不同职业中以农民人群最多(83例,39.90％)),僧人最少(2例,0.96％);男性伴肝病比例明显高于女性(P=0.001);有肝炎病史者185例(88.9％),其中伴乙肝152例(73.08％),伴酒肝66例(31.73％),同时伴乙肝和酒肝者37例(17.79％),伴肝包虫者3例(9.1％),无肝病史者23例(11.05％).208例PLC病例中农民乙肝患病率高于公务员(P=0.027),农民乙肝患病率高于工人(P=0.016),公务员酒肝患病率高于农民(P＜0.0001);农民酒肝发病率高于工人(P=0.005);牧民酒肝患病率高于工.人(P=0.016);公务员酒肝患病率高于牧民,差异有统计学意义(P=0.002);世居海拔以3001-4000m为主(128例,61.5％).结论 西藏地区高原世居藏族PLC发病人群以男性为主,主要为伴乙肝病史的中年男性农民和伴酒肝病史的中年男性公务员人群,其主要发病年龄段与内地和国外无明显差异;其中不同年龄、性别、职业、肝病史与PLC的发病存在一定的关系;其中僧人极低的PLC发病人群是否与饮食有关,该区肝包虫的高发病率与PLC的发生是否有相关性,需进一步研究证实.

As the head transplant program“Heaven Surgery” was put forward, there was birth to many bioethi-cal confusion, clinical-medical ethical confusion and other questions of ethical confusion. Face with various ethi-cal confusions, clinician need rational return of humanism, and the public need pay more attention to the essence of life and the concept of life and death.

目的 总结行TACE联合手术切除治疗中晚期肝癌的经验.方法 笔者对2009～2014年间我科收治的4例中晚期肝癌行TACE联合手术治疗患者的临床资料进行回顾性分析.结果 4例病例各在术前接受TACE治疗2～4次,经评估可行手术切除后,均行肝脏不规则切除术.术后均未出现严重并发症,无围手术期死亡.结论 中晚期HCC术前先行TACE治疗使肿瘤缩小后,行手术切除不仅有较高的安全性,而且得到比较满意的预后.

The present study examined the role of CD14 in the regulation of lipopolysaccharide (LPS)-induced effects on gastric cancer cells. MGC-803 cells were stably transfected with CD14 short hairpin (sh)RNA and treated with LPS, followed by assessment of cell proliferation, apoptosis and gene expression using a cell counting kit-8 assay, flow cytometry, reverse transcription-polymerase chain reaction and western blot analysis, respectively. The cells subjected to CD14 knockdown were treated with 10 g/ml LPS and injected into nude mice to form tumor xenografts. CD14 shRNA-transfected MGC-803 cells did not exhibit any significant changes in cell viability compared with the control cells (P>0.05), but cell viability was markedly increased in the wild-type (WT) + LPS group (P<0.05). In contrast to the WT + LPS group, the cell viability of the sh-CD14 + LPS group was markedly decreased (P<0.05). In addition, compared with those in the controls, the level of sh-CD14 cell apoptosis did not change significantly; however, it was markedly reduced in the LPS group. Compared with that in the WT + LPS group, the rate of apoptosis in the sh-CD14 + LPS group increased to a certain extent, while it remained lower in the control group. In addition, compared with that in the control, the expression of tumor necrosis factor-alpha, interleukin (IL)-1, IL-6 and IL-12, and human beta-defensin 2 was significantly increased in the WT + LPS group, while, compared with that in the WT + LPS group, the expression of these genes was markedly reduced in the sh-CD14 + LPS group (P<0.05). The nude mouse experiments further confirmed the in vitro data, including the finding that LPS promoted the growth of xenografts, but knockdown of CD14 expression reduced the response of tumor cells to LPS treatment. In conclusion, LPS induced cell viability and the release of inflammatory cytokines, but inhibited gastric cancer cell apoptosis. Knockdown of CD14 expression had no significant effect on gastric cancer malignancy, but mediated LPS signal transduction.

AIM:To investigate the relationship between CD14-260and-651 polymorphisms and the risk of developing gastric cancer.METHODS:DNA was extracted from peripheral blood samples obtained from 225 Tibetans with gastric cancer and 237 healthy Tibetans,and analyzed using the polymerase chain reaction/ligase detection(PCR/LDR)method to determine the genotypes at-260 and-651loci of the CD14 promoter.The allele frequencies,genotype frequencies,and haplotypes were analyzed for their association with gastric cancer risk using online SHEsis software.The luciferase reporter assay and point mutation analysis were used to construct in vitro plasmids expressing a C/T homozygote at the-260 lo-cus of the CD14 promoter.RESULTS:The frequencies of CC,CT and TT genotypes in the CD14-260 C/T locus in gastric cancer patients were 19.1%,38.7%and 42.2%,respectively,whereas they were 33.3%,32.5%and 34.2%,respectively,in healthy control subjects.CT genotype carriers were more frequently found among gastric cancer patients than healthy controls(OR=2.076;95%CI:1.282-3.360).Also,TT genotype carriers were more frequently found among gastric cancer patients(OR=2.155;95%CI:1.340-3.466).Compared to the C allele of CD14/-260,the T allele was associated with an increased risk for gastric cancer(OR=1.574;95%CI:1.121-2.045).Furthermore,the frequencies of CC,CT and TT in the CD14-651 C/T locus in gastric cancer patients were 64.4%,29.3%and 6.2%,respectively,while they were 56.5%,35.0%and 8.4%,respectively,in the healthy control subjects(P>0.05).Data obtained using the luciferase reporter assay showed that the p260T homozygote was associated with greater CD14 promoter activity(P<0.01).CONCLUSION:CD14/-260 polymorphism is associated with gastric cancer risk in Highland Tibetans and affects CD14 promoter activity,thereby regulating CD14expression.

<正>患者男,藏族,35岁,反复上腹疼痛2月入院。腹部B超:肝左叶实性占位病变待查;腹部CT示:肝右叶顶部及肝尾叶占位性病变,肝癌可能性大,肝内胆管及胆总管扩张。CA-199:229U/ML。前往内地医院就诊,MRI:肝左叶内侧段块影,考虑胆管源性肿瘤可能性大,胰头上方淋巴结肿大坏死,胆总管中下段、右

目的总结7例藏族恶性肿瘤患者化疗后重度骨髓抑制患者临床表现、治疗方法。方法回顾性分析7例藏族恶性肿瘤患者化疗后重度骨髓抑制患者的临床资料、治疗方法。结果 4例患者为Ⅳ度白细胞抑制,2例患者为Ⅳ度血小板抑制的治疗,1例出现肺部真菌感染,1例出现颅内出血。通过治疗对5例患者治疗骨髓抑制恢复,2例患者死亡。结论 7例藏族恶性肿瘤患者化疗后出现重度骨髓抑制,易出现严重并发症,治疗不当甚至出现死亡,合理、有效的治疗能使患者骨髓抑制得到平稳恢复,降低并发症的发生。

胃癌是我国常见恶性肿瘤,病死率高,以往报道西藏地区为我国胃癌高发区之一[1],近年来此地区胃癌检出患者不断增多,对人民群众的健康造成严重威胁.为进一步了解高原地区胃癌临床特点,现对我院2009年1月至2012年12月住院治疗的237例胃癌患者的临床资料进行回顾性分析,现报告如下.

Objective To observe the effect of CD14 on the biological behaviors of gastric cancer cells SGC-7901 and discuss its function in the occurrence and development of gastric cancer.Methods The gastric cancer cells SGC-7901 stably transfected with CD14 were stimulated with muramyl dipeptide(MDP) of CD14 receptor.The activity and proliferation capacity of cells were detected with CCK-8 method and plate clone formation assay.The effect of CD14 on apoptosis was detected with flow cytometry and the invasion ability of cells was detected with Transwell invasion model.Results The activity of gastric cancer cells SGC-7901 stably transfected with CD14 was significantly reduced(P < 0.05).The clone formation rate of gastric cancer cells SGC-7901 stably transfected with CD14 was 15.66% ± 5.94% and that of transfected empty plasmid group was 19.28% ± 5.48%,with statistical difference(P < 0.05).The apoptosis rate of gastric cancer cells SGC7901 stably transfected with CD14 was 14.38% and that of transfected empty plasmid group was 4.58%,with statistical difference(P < 0.05).The invaded cells at 24h and 28h were(69.40 ± 6.73) and(108.20 ± 9.68) and those of transfected empty plasmid group were(81.40 ± 7.80) and(133.20 ± 12.87),with statistical difference(P < 0.05).Conclusion CD14 can promote the apoptosis of gastric cancer cells SGC-7901 as well as inhibit their proliferation and invasion.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解西藏高原地区藏族人群胃癌患病的相关危险因素,为制订有效胃癌防治策略提供依据。方法采用1:1配对病例对照研究方法,在西藏自治区人民医院对116例新发的胃癌患者及116名同期参加健康体检人群进行问卷调查,分析胃癌发病的影响因素。结果单因素logistic回归分析结果显示,常生闷气（OR=2.812）、吸烟（OR=1.908）、饮食不规律（OR=2.484）、慢性胃炎（OR=2.164）、胃溃疡（OR=2.105）、肿瘤家族史（OR=3.367）、高盐饮食（OR=2.792）、粗糙食物（OR=2.337）、干硬食物（OR=3.164）为高原地区胃癌发病的主要危险因素;多因素logistic回归分析结果显示,饮食不规律（OR=2.912,95%CI=1.099⁷.718）、长期食用干硬食物（OR=2.580,95%CI=1.155⁵.765）、喜食高盐饮食（OR=2.653,95%CI=1.287⁵.469）、慢性胃炎病史（OR=2.254,95%CI=1.141⁴.419）及肿瘤家族史（OR=3.356,95%CI=1.167⁹.652）是高原藏族人群胃癌发生的主要危险因素。结论高原地区胃癌的发病可能与不良的饮食习惯、长期患有胃病史以及肿瘤家族史有关,应因地制宜制定科学的预防措施。</span>

Objective To assess the effects of over-expression of CD14 upon the activity of gastric cancer cell nuclear factor-κB(NF-κB) and the expression of Human β-Defensin-2(hβD-2),and discuss the role of CD14 in the emergence and progression of gastric cancer.Methods SGC-7901 cell lines stably transfected with CD14 and control cells transfected with empty plasmid alone were cultured in vitro.The obtained cells were stimulated by CD14 muramyl dipeptide.The activity of NF-κB was assessed by electrophoretic mobility shift assay.The expression of NF-κB protein was detected by Western blot.The expression of hBD-2 at mRNA and protein levels was measured by RT-PCR and Western blot,respectively.Results Compared with control cells,the activity of NF-κB in cells with over-expression of CD14 was significantly enhanced and the expression of protein was also remarkably increased.Meanwhile,the expression of hβD-2 at mRNA and protein levels was elevated to certain extent.Conclusion CD14 in gastric cancer cells plays a key role in mediating the activation of NF-κB and the expression of hβD-2.

Cluster of differentiation 14 (CD14) protein functions as a co-receptor with either the Toll-like receptor TLR4 or MD-2 in the detection of bacterial lipopolysaccharide (LPS) and plays a role in the innate immune system. Recently, it was shown to have effects on the regulation of epithelial-mesenchymal transition (EMT). Thus, the present study investigated the effects of CD14 knockdown on the regulation of gastric cancer cell EMT and invasive capacity following treatment with or without LPS. Knockdown of CD14 expression using CD14 shRNA in MGC-803 cells significantly enhanced E-cadherin expression, but reduced N-cadherin and vimentin expression in both LPS-treated and untreated cells. Morphologically, the phenotype of LPS-treated CD14-knockdown cells was altered to a sporadic long spindle shape. Moreover, TNF-α-treated cells were further elongated, connections between cells were reduced, the gap between the cells was increased and the cells were transformed into mesenchymal cells. Furthermore, the invasive capacity of CD14-knockdown cells was significantly lower compared to that of the negative control shRNA-transfected MGC-803 cells. LPS-treated CD14-knockdown cells had significantly lower levels of tumor cell invasive ability when compared to the LPS-treated parental MGC-803 cells. However, addition of TNF-α to LPS-treated CD14-knockdown cells significantly increased tumor cell invasion. This study demonstrated that CD14 promoted tumor cell EMT and invasion through TNF-α, whereas knockdown of CD14 expression inhibited gastric cancer cell invasion and EMT.

Objective To study the effect of CD14 overexpression in gastric cancer cells on TNF-α,IL-1β, IL-6 and IL-12 and discuss its function in the occurrence and development of gastric cancer .Methods The gastric cancer cells SGC-7901 stably transfected with CD14 were stimulated with muramyl dipeptide ( MDP) of CD14 receptor.mRNA expression and protein expression of each cell factor was detected with RT -PCR and Western blot , respectively .The gastric cancer cells SGC-7901 transfected with empty plasmid was as the control and the effect of enforced CD14 expression on expression of TNF-α,IL-1β,IL-6 and IL-12 was discussed .Results mRNA expression and protein expression of TNF-α,IL-1β,IL-6 and IL-12 were increased in the cells stably transfected with CD 14. Conclusions CD14 plays a role in increasing expression of TNF-α,IL-1β,IL-6 and IL-12 to a certain extent .

CD14 mediates the inflammatory response via recognition of lipopolysaccharide, which has been implicated in Helicobacter pylori ( H. pylori ) infections. Increasing evidence has suggested that CD14 status significantly influences the clinical outcome of H. pylori infection, which can result in gastric carcinoma. However, there is little evidence regarding the cellular impact and associated molecular basis of CD14 on gastric carcinoma cells. To address this question, we generated a CD14-overexpressing SGC-7901 gastric carcinoma cell line and analyzed the impact of CD14 expression. Our results revealed that cells overexpressing CD14 exhibited antitumor potential, including significantly decreased clonogenic ability, proliferation, metastatic invasion, as well as enhanced apoptosis, suggesting a tumor-suppressive role of CD14 in the cells. Intriguingly, we further discovered that CD14 overexpression activated NF-κB via upregulating its expression and simultaneously stimulating DNA binding activity. Upregulated NF-κB transcriptionally elevated a series of pro-inflammatory cytokines, including TNF-α, IL-1β, IL-6, and IL-12. Together, the current study utilized a CD14-overexpressing gastric cell model to determine the impacts of CD14 upregulation on cell viability, apoptosis, and migration and NF-κB-mediated inflammation.