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    25 September 2012, Volume 4 Issue 3 Previous Issue    Next Issue
    Strategies of comprehensive treatment on nasopharyngeal carcinoma
    ZENG Lei, LU Tai-Xiang
    2012, 4 (3):  205-209.  doi: 10.3969/j.issn.1674-5671.2012.03.01
    Abstract ( 331 )   PDF (921KB) ( 879 )   Save
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    Modern integrated treatment on nasopharyngeal carcinoma
    LIANG Yun, BAI Li-Zhu
    2012, 4 (3):  210-213.  doi: 10.3969/j.issn.1674-5671.2012.03.02
    Abstract ( 378 )   PDF (1264KB) ( 545 )   Save
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    Combination of SELDI-TOF-MS with protein microarrays to screen serum biomarkers in patients with poorly differentiated nasopharyngeal squamous cell carcinoma
    LI Ling, ZHU Xiao-Dong, Su-Fang, QU Song, Wang-Qi, LI Li, ZHANG Wei
    2012, 4 (3):  214-217.  doi: 10.3969/j.issn.1674-5671.2012.03.03
    Abstract ( 452 )   PDF (334KB) ( 463 )   Save
    Objective To explore the clinical value of screening possible serum tumor markers in patients with poorly differentiated nasopharyngeal squamous cell carcinoma. Methods Surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS)and a CM-10 protein chip were used to determine the serum proteomic patterns of 61 patients with poorly differentiated nasopharyngeal squamous cell carcinoma before radiotherapy and 72 healthy subjects. Proteomic spectra of serum samples collected from 40 patients and 40 healthy controls were used as training sets.The validity of the classification trees were then challenged with blind test sets, which included another 21 patients with poorly differentiated nasopharyngeal squamous cell carcinoma and 32 healthy controls. Biomarker Wizard 3.01 and Biomarker Pattern 5.01 software were used together to analyze the data and develop diagnostic models. Results The accuracy,sensitivity and specificity tested by blinded detection were 86.8%,81.0% and 90.6%,respectively.The accuracy of 3 protein peaks(M4890,M5710 and M7780)was 73.7% for predicting stage I and II,and 81.0% for predicting stage III and IV of poorly differentiated nasopharyngeal squamous cell carcinoma. Conclusion SELDI-TOF-MS combined with bioin-formatics tools provides a new approach for qualitative diagnosis of poorly differentiated nasopharyngeal squamous cell carcinoma.
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    Optimization of split-filling and simultaneous boost irradiation protocols for locally ad-vanced nasopharyngeal carcinoma based on observed clinical effects
    HUANG Xiao-Bo, ZHANG Wei-Dong, HU Dan, KANG De-Hua, HE Zhi-Chun, XIA Yun-Fei
    2012, 4 (3):  218-224.  doi: 10.3969/j.issn.1674-5671.2012.03.04
    Abstract ( 404 )   PDF (881KB) ( 448 )   Save
    Objective To explore reasonable fractioned doses, optimized field and application time of split-filling and simultaneous boost irradiation(SF-SBI)in patients with locally advanced nasopharyngeal carcinoma(NPC)involving extensive,C-shaped invasion of the skull base,posterior cranial fossa and post-styloid parapharyngeal space. Methods Six patients with locally advanced NPC treated at the Cancer Center of Sun Yat-sen University between January 2004 and June 2008 were enrolled in this study. Different SF-SBI schemes were used for the patients,and dose volume histograms(DVHs)were used to analyze dosimetric characteristics of boost tumor volume(BTV),primary tumor planning target volume(PTVnx)and organs at risk (OARs).Clinical efficacy and complications were e-valuated for each patient. Results The mean dose(Dmean)of BTV was 73.8~76.2 Gy and the target volume percentage contained by the 95% prescribed dose curve(V95%)of BTV was 95.8%~99.9%.The Dmean and V95% of PTVnx was 70.3~75.9Gy and 96.0%~99.9%,re-spectively.No volume received more than 80Gy for PTVnx and BTV.The V95% of PTV1 and PTV2 was 98.8%~99.9% and 98.9%~99.9%,respectively.The volume percentage at 50 and 60Gy(V50,V60)were 13.2%~46.3% and 2.6%~12.8%,respectively;the maximum dose for 33% volume(D33)of the brain stem was 23.8~53.9Gy.The Dmean,D33 and V60 of the ipsilateral temporal lobe were 23.8~32.2Gy,26.4~39.2Gy and 19.5%~25.7%,respectively.The temporal lobe percentage volume of patients A,B and C was 9.5%, 32.2% and 28.7%, respectively. The Dmean and D50 of the ipsilateral temporo-mandibular joint were 69.1~76.2Gy and 62.2~69.8Gy,respectively. Follow-up time was 3.5 to 7 years. Except patient A,who showed partial remission(PR),the remaining patients showed complete remission(CR)during or after radiotherapy.None of the patients showed local tumor progression or tumor recurrence,and none showed signs of brain stem injury.Patients treated with a large fractioned dose(2.4~2.7Gy)suffered radiation encephalopathy,cranial nerve in-jury or severe trismus. Conclusion This study describes an improved SF-SBI conformal radiotherapy technique for personalizing treatment of patients with locally advanced NPC.The fraction dose in this technique is 2.3Gy for BTV and most of GTV from the beginning of radiotherapy.In this approach,the radiotherapy field can be reduced based on observed regression of individual tumors.
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    A dosimetric comparison between IMRT and Arc treatment plan for nasopharyngeal carcinoma
    QIU Da, TAN Bing, WAN Yue, WANG Ying, JIN Fu, WU Yong-Zhong
    2012, 4 (3):  225-228.  doi: 10.3969/j.issn.1674-5671.2012.03.05
    Abstract ( 522 )   PDF (271KB) ( 536 )   Save
    Objective To examine intensity modulated radiation therapy(IMRT) and Rapid Arc treatment plan for nasopharyngeal carcinoma,and to provide a reference for clinical selection of radiotherapy plans. Methods Ten patients with nasopharyngeal carci-noma(NPC) were enrolled and underwent CT simulation.The clinical target volume(CTV) was contoured on the CT image,and the planning target volume(PTV) was defined according to the s ame criteria.Nine-field IMRT(IMRT9),single arc(Arc1),double arc (Arc2) and triple arc(Arc 3) Rapid Arc plans were generated for each patient.All plans were prescribed 70 Gy.The dosimetric parameters of target volume and organ at risk(OAR),the monitor units(MU) and treatment time were compared between IMRT and arc treatment plan. Results The conformity index(CI) and HI of PTV for IMRT were superior to those for Arc1,and were similar to those for Arc2 and Arc3,and all the OAR for various plans were lower than the reference limited dose.MU of Arc was significantly lower than that of IMRT plan,and treatment time of Arc was shorter than that of IMRT. Conclusions Although the IMRT plan is recommended for dosimetry, the Arc plan shows a distinct advantage for its short treatment time and small MU number.
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    Feasibility of cone beam CT image-guided adaptive radiotherapy to treat esophageal carcinoma
    FU Qing-Guo, WANG Lei-Li, LIANG Shi-Xiong, ZHAO Wei, WU Chun-Hua
    2012, 4 (3):  229-232.  doi: 10.3969/j.issn.1674-5671.2012.03.06
    Abstract ( 544 )   PDF (325KB) ( 708 )   Save
    bjective To investigate the feasibility of reducing the exposure dose on normal tissue by creating a specific planning target volume(PTV) using cone beam computed tomography(CBCT) imaging during the first week of radiotherapy in patients with esophageal carcinoma. Methods Ten patients with esophageal carcinoma treated by radical radiotherapy were investigated.CBCT images were acquired on days 1~5 of the first week of radiotherapy and once a week later.The images were imported into the planning system and matched with the planning CT for the same treatment position.The same tumor and esophagus as in the initial plan(plan A) for the length of the clinic target volume(CTV) were contoured on each CBCT image.Then CTV was contoured again on each CBCT image according to the plan prior to radiotherapy. The PTV was defined as CTV(tumor,nodes) plus setup error,which was acquired during the first weeks of treatment.A composite volume(PTV1) was created by combining the five CBCT volumes in the first week.PTV2 was generated in the same way using the five CBCT volumes of weeks 2~6.An adaptive plan(plan B) was formulated based on the PTV1 target in order to maintain the same radiation planning parameters and target prescription dose as in plan A, while limiting the exposure dose to organs at risk.Coverage of the 95% prescription isodose was evaluated on PTV1 and PTV2 with the same radiation planning.Dose-volume histograms(DVHs) for lung, heart and spinal cord of the two plans were compared. Results For the adaptive plan,the coverage of the 95% prescription isodose for PTV1 was 95.5±3.4%(P=0.001),while for PTV2 it was 99.1±1.7% (P=0.001).Several parameters with plan B were significantly smaller than with plan A(P<0.05):lung V20(25.1% vs 26.9%) and mean dose(14.1Gy vs 15.1Gy),heart mean dose(26.9Gy vs 20.7Gy) and spinal cord maximum dose(41.5Gy vs 42.9Gy). Conclu-sions A reduced planning volume can be constructed based on CBCT images acquired during the first week of radiotherapy.The modified plan can be implemented in the follow-up treatment,considerably reducing the dosage on organs around the target area and potentially increasing the dosage on the target.
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    Intensity-modulated radiotherapy for 69 locally recurrent nasopharyngeal carcinoma cases: analysis of efficacy and prognostic factors
    WU Ting-Ting, MA Li-Qin, QIU Su-Fang, ZHANG Yu, PAN Jian-Ji, Yang- Ling, LIN Shao-Jun
    2012, 4 (3):  233-237.  doi: 10.3969/j.issn.1674-5671.2012.03.07
    Abstract ( 487 )   PDF (360KB) ( 541 )   Save
    Objective To examine retrospectively the efficacy and prognostic factors of locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy(IMRT). Methods Sixty nine locally recurrent NPC patients were performed IMRT,the second irradiation total prescription dose was 49.5~77.4Gy(median fractional dose 66Gy),and fractional dose was 1.86-2.5Gy(median fractional dose 2.1Gy).Forty eight patients were treated with 1~6 courses of cisplatin-based chemotherapy. Results The median follow-up time was 20 months.The rates of 1-year local progression-free survival,distant metastasis-free survival, and overall survival were 92.9%,81.8% and 81.8%,respectively.The rates of 2-year local progression-free survival, distant metastasis-free survival, and overall survival were 88.8%,65.5% and 65.5%,respectively. The result of univariate analysis showed that both the first RT modality(P=0.004) and the second irradiation dose(P=0.011) were positively related to the survival time,respectively.The result of multivariate analysis showed that both the first RT modality(P=0.004) and the second irradia-tion dose(P=0.004) influenced the prognosis of recurrent NPC after radiotherapy.The toxicity response during radiotherapy was well tolerated in patients. Conclusion IMRT is effective to locally recurrent NPC and can improve survival rate.Both the first RT modality and the second irradiation dose are independent prognostic factors of the overall survival for locally recurrent NPC patients.
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    Construction of a lentiviral vector for RNA interference of the ITIH4 gene
    HUANG Min, WANG Qi, ZHANG Wei, LI Li
    2012, 4 (3):  242-246.  doi: 10.3969/j.issn.1674-5671.2012.03.09
    Abstract ( 414 )   PDF (422KB) ( 464 )   Save
    Objective To construct a lentiviral vector for RNA interference of the inter-α-trypsin inhibitor H4 (ITIH4) gene. Methods A short hairpin RNA (shRNA) targeting the ITIH4 gene was designed based on the optimal siRNA sequence. The double-stranded DNAs obtained after annealing were ligated with the linearized lentiviral vector Psico using T4 DNA ligase and transformed into E. coli. The recombinant plasmid was extracted and identified by PCR and sequencing. The plasmid DNA of Psico-shRNA-ITIH4 was packaged into 293 T cells, and the fluid virus titer in the culture medium was determined. Results The sequence of recombinant lentiviral plasmid Psico-shRNA-ITIH4 was consistent with the sequence of the designed shRNA. The virus titer was approximately 9.5 × 103 IU/ml. Conclusion The recombinant plasmid Psico-shRNA-ITIH4 was constructed successfully and provides an experimental basis for the further study of ITIH4.
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    Expression and clinical significance of RASSF1A and Elf-1 in non-small cell lung cancer
    KONG Li-Jun, HU Jin-Xia, ZHANG Han-Han
    2012, 4 (3):  246-251.  doi: 10.3969/j.issn.1674-5671.2012.03.10
    Abstract ( 359 )   PDF (362KB) ( 404 )   Save
    Objective To explore the correlation between the expression of RASSF1A and Elf-1 proteins and clinicopathological fea-tures of non-small cell lung cancer(NSCLC). Methods A tissue chip array containing 72 NSCLC tissue samples and 10 normal lung tissue samples was constructed,and immunohistochemistry(PV9000)was used to measure the expression of RASSF1A and Elf-1 pro-teins. Results Both RASSF1A and Elf-1 were heterogeneously expressed in NSCLC tissue. RASSF1A protein was expressed in 34/72 (47.22%) of NSCLC tissues,a significantly lower proportion than the 10/10(100%) of normal lung tissues expressing RASSF1A.In addition,RASSF1A protein levels differed significantly between NSCLC tissue and normal lung tissue(P=0.002).For example, RASSF1A protein levels were significantly higher in cases with lymph node metastasis than in cases without it(X2=4.379,P=0.036). Significant differences were also observed between groups at different clinical stages(X2=17.979,P=0.000).Elf-1 protein was detected in 53/72(73.61%) of NSCLC tissues but in only 2/10(20%) of normal lung tissues.Elf-1 protein levels differed significantly between the two types of tissue(P=0.001).Expression of Elf-1 was related to tumor differentiation(X2=7.116,P=0.028),lymph node metastasis (X2=5.304, P=0.021) and clinical staging(X2=6.791, P=0.034).Levels of RASSF1A and Elf-1 proteins correlated negatively with each other in NSCLC tissue(r =-0.433,P =0.000). Conclusions The down-regulation of RASSF1A and up regulation of Elf-1 may be asso-ciated with the occurrence,progression and prognosis of NSCLC.The relative expression of RASSF1A and Elf-1 may play an impor-tant role in early diagnosis of NSCLC,and serve as a molecular indicator for predicting invasion and metastasis.
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    Correlation of ERCC1 and RRM1 expression and survival prognosis in non-small cell lung cancer patients
    LIU Bin, LIU De-Sen, PAN Hong, LUO Yuan, WU Ping-Shang, Chen-Jie-Min
    2012, 4 (3):  251-255.  doi: 10.3969/j.issn.1674-5671.2012.03.11
    Abstract ( 444 )   PDF (966KB) ( 450 )   Save
    Objective To explore the effects of excision repair cross-complementing 1(ERCC1) and ribonucleotide reductase subunit (RRM1) protein expression on survival prognosis of stage I-IIIa non-small cell lung cancer(NSCLC) patients. Methods ERCC1 and RRM1 protein expression was detected in stage I-IIIa NSCLC patients using immunohistochemistry.The survival prognosis of the pa-tients was analyzed by survival analysis. Results Neither ERCC1 nor RRM1 expression was associated with gender,age,histological type,or TNM stage.The survival prognosis of ERCC1-and RRM1-positive patients in stage Ia was better than that of ERCC1-and RRM1-positive patients in other stages.ERCC1-negative patients in stage Ib-IIIa may benefit from platinum-containing chemotherapy,which may provide a survival advantage.RRM1-negative patients were sensitive to gemcitabine, which provided a survival advantage. ERCC1 expression positively correlated with RRM1 expression(P<0.05) in stage I-IIIa NSCLC patients. Conclusion Chemotherapeutic effect and prognosis of patients with stage I-IIIa NSCLC can be predicted by detecting ERCC1 and RRM1 expression,which may allow for individualized treatment plans.
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    Expression and clinical significance of LUNX mRNA in non-small cell lung carcinoma
    LIAO Xu-Qiang, LIU Tao, LIANG Xiang-Sen, XIAN Lei, CHEN Ming-Wu, GUO Jian-Ji
    2012, 4 (3):  256-259.  doi: 10.3969/j.issn.1674-5671.2012.03.12
    Abstract ( 510 )   PDF (308KB) ( 390 )   Save
    Objective To explore the expression and clinical significance of lung specificity protein X(LUNX)mRNA in peripheral blood of patients with human non-small cell lung carcinoma(NSCLC). Methods Reverse transcription-polymerase chain reaction(RT-PCR) was used to measure the expression of LUNX mRNA in peripheral blood of 56 NSCLC patients and 34 patients with benign lung lesions.The relationship between LUNX mRNA expression levels and clinicopathological features was analyzed. Results ①LUNX mRNA was expressed in 58.93% of NSCLC patients,while no expression was detected in patients with benign lung lesions(P<0.05). ②LUNX mRNA expression correlated closely with lymph node metastasis and with the degree of differentiation and clinical stage of NSCLC(P<0.05).However,no correlation was observed between LUNX mRNA expression and other clinicopathological features such as age,sex,smoking history,tumor location or pathology type(P>0.05). Conclusions LUNX mRNA may serve as an important molecular indicator for evaluating the occurrence and development of NSCLC patients,and it may play an important role in clinical diagnosis and therapy. 
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    Relationship between chemotherapeutic response and 131I-EGF uptake in a mouse model of lung cancer
    LIU Zhong, WANG Su-Jie
    2012, 4 (3):  259-262.  doi: 10.3969/j.issn.1674-5671.2012.03.13
    Abstract ( 440 )   PDF (355KB) ( 363 )   Save
    Objective To evaluate the feasibility of using 131I-EGF to assess tumor response to chemotherapy. Methods BALB/c-Anu mice were inoculated with A549 lung adenocarcinoma cells,and randomly divided into four groups when tumor diameters reached 0.8~1.2cm:the control group was treated with 0.1ml of saline;the taxol group,with 5mg/kg of taxol;the cisplatin group,with 4mg/kg of cisplatin;and the combined chemotherapy group,with 5mg/kg of taxol and 4mg/kg of cisplatin.Scintigraphic studies were conducted at 0,7,14,21 and 28 d after the treatments.The ratio of radioactivity of tumor to non-tumor tissue(T/NT)was calculated using the region of interest(ROI)technique.After the last imaging,the mice were sacrificed. The ratios of radioactivity in tumor/blood and tumor/muscle were also measured.Tumor volume was determined and used to calculate tumor growth inhibition rates in each group.Dynamic images were acquired every 0.5min for the first 30min,using a SPECT system.The biodistribution of 131I-EGF was determined at the end of the imaging session. Results Tumors could be clearly visualized on the 131I-EGF images. The distribution of 131I-EGF showed that chemotherapeutic groups had lower tumor/muscle radioactivity ratio(taxol,9.829;cisplatin,12.636;combined,12.313) and tumor/blood ratios(taxol,3.384;cisplatin,2.826;combined,2.713) than the control group(all P<0.05).Similarly,T/NT ratios in the three chemotherapy groups were significantly lower than in the control group(F=1011.251,P<0.01).Differences between the control group and each treatment group were consistent with the relative tumor volumes in each group. Conclusions There may be a correlation between 131I-EGF uptake and therapeutic efficacy after chemotherapy in tumor tissue,suggesting that 131I-EGF may be useful for evalu-ating tumor response to treatment. 
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    The relationship between microsomal epoxide hydrolase (EPHX1) polymorphism and genetic susceptibility to hepatocellular carcinoma: A meta-analysis
    MA Liang, HUANG Sheng-Xin, LI Jian, HUANG Shan, ZHAO Yin-Nong, LI Le-Qun, WU Fei-Xiang
    2012, 4 (3):  263-267.  doi: 10.3969/j.issn.1674-5671.2012.03.14
    Abstract ( 481 )   PDF (382KB) ( 496 )   Save
    Objective To explore the relationship between microsomal epoxide hydrolase(EPHX1)polymorphism and genetic sus-ceptibility to hepatocellular carcinoma(HCC). Methods Both English- and Chinese-language databases were searched for relevant lit-erature on the relationship between EPHX1 polymorphism and HCC using a preformulated search strategy.Data on the association were evaluated using odds ratio(ORs)with 95% confidence intervals(CIs), and heterogeneity of included studies was assessed. Meta-analysis of published data was carried out using Stata 12.0 software. Results Nine studies were included based on the selection crite-ria 8 studies,involving 584 cases and 989 controls,examined the EPHX1 polymorphism 337T>C.Significant increased risk of HCC was found using the additive model[C vs T OR(95%CI)=1.47(1.26~1.72),P<0.001],homozygote comparison[CC vs TT OR(95%CI) =1.88(1.40~2.52),P<0.001],and the recessive model[CC vs CT/TT OR(95%CI)=1.73(1.36~2.21),P<0.001].A total of 6 studies in-volving 432 cases and 699 controls examined the EPHX1 polymorphism 416A>G.Markedly decreased risk of HCC was observed using the additive model[G vs A OR(95%CI)=0.75(0.59~0.95),P=0.018]. Conclusions The EPHX1 polymorphism 337T>C is associated with HCC,and the CC genotype appears to be a risk factor.In contrast,the G allele of the EPHX1 polymorphism 416A>G may de-crease HCC susceptibility and therefore constitute a protective factor against HCC.
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    Clinical analysis of surgery on substernal goiter
    HE Chun, XIE Min-Ming
    2012, 4 (3):  270-271.  doi: 10.3969/j.issn.1674-5671.2012.03.16
    Abstract ( 364 )   PDF (239KB) ( 518 )   Save
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    Experience in diagnosis and treatment on liver cancer with repeated recurrence (Report of 1 case)
    LIN Zhi-Qiang, WANG Zai-Guo, HU Xia-Rong, ZHENG Jing-Lei, YU Wu, WANG Ming, HE Run-Pei, YE Zhen-Wei, HUANG Zhi-Tian, CHEN Liu-Zhen, LAI Guo-Wei
    2012, 4 (3):  272-273.  doi: 10.3969/j.issn.1674-5671.2012.03.17
    Abstract ( 502 )   PDF (248KB) ( 575 )   Save
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    Transumbilical single-port laparoscopic cholecystectomy:experience of 36 cases
    XIAN Jian-Yuan, MO Zong-Ming
    2012, 4 (3):  274-275.  doi: 10.3969/j.issn.1674-5671.2012.03.18
    Abstract ( 351 )   PDF (234KB) ( 422 )   Save
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    Perioperative care of patient with cervical trachea sleeve resection
    LIU  Hong, ZHANG Li-Zhen
    2012, 4 (3):  278-279.  doi: 10.3969/j.issn.1674-5671.2012.03.20
    Abstract ( 389 )   PDF (232KB) ( 417 )   Save
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    Reform education mode for training modern application-oriented oncology professionals
    YANG Wei-Ping, HUANG Na, WEI Chang-Yuan
    2012, 4 (3):  287-290.  doi: 10.3969/j.issn.1674-5671.2012.03.24
    Abstract ( 367 )   PDF (310KB) ( 591 )   Save
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    Research progress of MR tracking in vivo for SPIO-labeled stem cell after transplantation
    GONG Qing-Song, SU Dan-Ke, JIN Guan-Qiao
    2012, 4 (3):  291-294.  doi: 10.3969/j.issn.1674-5671.2012.03.25
    Abstract ( 412 )   PDF (309KB) ( 524 )   Save
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    Progress of TACE treatment on hepatocellular carcinoma
    MAN Yan-Wen, LIU Jian-Yong-
    2012, 4 (3):  295-298.  doi: 10.3969/j.issn.1674-5671.2012.03.26
    Abstract ( 437 )   PDF (301KB) ( 443 )   Save
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