In recent 20 years,liver transplantation has been rapidly developed in China,and the number of cases and patient outcomes have continued to improve.However,many problems emerged,such as mismatch of donor source and unbalanced distribution system,the research achievements lacking of innovation and core competitiveness,and clinical study level lags behind.In order to solve the problems mentioned above,the First Affiliated Hospital of Nanjing Medical University has carried out a series of work,such as expanding the donor pool,improving clinical technologies,and strengthening basic researches.

Songbirds and humans both rely critically on auditory feedback for learning and maintaining accurate vocalizations. During vocal learning, juvenile songbirds learn to sing by using auditory feedback to match their variable song patterns to a memorized tutor model. During song maintaining, adult songbirds monitor the integrality and accuracy of its song on-line according to auditory feedback. This form of learning requires auditory-vocal integration. The output of songs and the information of auditory feedback are integrated in some areas of the bird's brain, and then direct next vocal activity. In recent years, the lateral magnocellular nucleus of the anterior neostriatum (LMAN) has been demonstrated that it is necessary for feedback-dependent song decrystallization, and LMAN neurons exhibit highly selective responses to auditory presentation of the bird's own song (BOS). Moreover, the discovery of mirror neurons in the high vocal centre (HVC) also provides a significant clue for further study in songbirds. Here the progress of auditory feedback and the plasticity of vocal learning in songbirds are reviewed in recent years.

The high mortality of paraquat (PQ) poisonings is mainly due to the lack of effective treatments. The optimal method of extracorporeal removal of paraquat is often a matter of debate. Due to the lack of well-designed studies, we are often left with circumstantial evidence, and we must exercise our best clinical judgment as to whether extracorporeal paraquat removal is beneficial and if so, by what method. It is clear, however, that rapidity in paraquat removal is beneficial. Due to the urgent nature of treatment for paraquat poisoning, there may never be well-designed evidence-based studies to help guide us. In the meantime, we must continue to use less than ideal evidence and our own experience to guide our decision-making process. Most toxicologists recommend rapid initiation of charcoal haemoperfusion (CHP) to lower plasma PQ levels and to limit pulmonary and other organs uptake of PQ.

The high mortality of paraquat (PQ) poisonings is mainly due to the lack of effective treatments. Most toxicologists recommend rapid initiation of charcoal haemoperfusion (CHP) to lower plasma PQ levels and to limit pulmonary and other organs uptake of PQ. Although there are considerable evidences of CHP efficacy in the reversion of the fatal outcome resulting from PQ poisonings, the usefulness of this therapy has been the subject of significant controversy with several evidences published in the literature showing a lack of clinical benefit in numerous cases. Considering that the blood concentration at a given time is directly related to clinical outcome, the rebound in plasma paraquat concentration after haemoperfusion may be partly relate to the poor clinical benefit, but may indicate the necessity for prolonged haemoperfusion. Continuous rather than intermittent haemoperfusion has been advocated for treatment of paraquat poisoning. However, 24h daily conventional pump driven haemoperfusion is usually impossible to carry out due to bleeding complications. Plasmapheresis is also a blood purification process. Unselective therapeutic plasma exchange is the first technology used for therapeutic apheresis (TA). However, limited efficacy by restricted plasma volume that can be exchanged in a single session is one of the severe limitations. To further increase the clearance of target molecules, plasma perfusion (PP) techniques was developed. modification of the conventional plasma perfusion in patients with paraquat poisoning has been reported and plasma levels of paraquat were reduced effectively.

The morbidity of transient hypothyroxinemia of prematurity (THOP) was high. There is controversial about thyroid hormone supplementation in THOP. Clinical studies suggest that thyroid hormone supplementation can reduce the incidence of patent ductus arteriosus,but no effect on the mortality and the incidence of respiratory disease.Thyroid hormone supplementation can improve the neurodevelopmental outcomes in infants with gestational age less than 28 weeks with THOP, but no effect on infants with gestational age more than 28 weeks. Future research should focus on the normal range of thyroid hormone according to gestational age in preterm infants,and randomized clinical trial welldesigned stratified according to gestational age to study the long-term neurodevelopmental outcome of thyroid hormone replacement therapy in infants with THOP

Biological performances of Ni-Cr porcelain alloy are highly correlated with released metallic ions. Released metal ions from Ni-Cr porcelain alloy, particularly Ni, Be can induce inflammation of the adjacent periodontal tissue and oral mucosa. In vitro evidence has indicated that the immune response can be altered by various metal ions. Allergic reactions due to metallic dental restorations have been documented. Ni has especially been identified as being highly allergenic. The cytotoxicity and corrosion level of Ni-Cr porcelain alloy is increased after recasting. The Ni-Cr porcelain alloy produced according to technology requirements has good biological safety. Ni-Cr porcelain alloy released a few of metal ions which might induce allergy and density of adjacent periodontal tissues, for the stimulation effect of these metal ions. There is no evidence to suggest that Ni-Cr porcelain alloy restorations has systemic toxicity or carcinogenic/genotoxic effect to human.

Objective To investigate the influence of blood pressure level on carotid intima‐media thickness (CIM T ) and plaque in elderly patients with coronary heart disease(CHD) .Methods 100 elderly CHD patients with hypertension admitted in our hospital from Jan .to Dec .2012 was collected .an epidemiological investigation was applied ,and blood pressure was measured .carotid CIMT and plaque were determined by colored Doppler ultrasound .multivariate linear regression model or Logistic regression model was used to analyze the effect of blood pressure on CIMT and plaque .Results A total of 100 subjects were enrolled .CIMT and plaque prevalence were (0 .7 ± 0 .1)mm ,45 .8% in 48 males and (0 .7 ± 0 .1)mm ,34 .6% in 52 females .the difference was statisti‐cally significant(χ2 =5 .609 ,P=0 .018) .multiple regression models showed that ,after adjusting relevant factors ,CIMT increased 0 .001 14 mm with SBP 1 mm Hg increase and CIMT increased 0 .001 18 mm with pulse pressure 1 mm Hg increase in males .Lo‐gistic regression model showed that the risk of plaque number >1 was higher in grade Ⅲhypertension compared to grade 1 hyper‐tension(OR= 2 .115 ,95% CI= 1 .128~ 3 .966 ,P= 0 .020) .Conclusion Elderly CHD patients with hypertension ,especially in males ,carotid CIMT increase while systolic BP and high pulse are high ,which cause the high risk of carotid artery plaque;hyperten‐sion is a independent risk factor for atherosclerosis in elderly CHD patients .

OBJECTIVE To explore the characteristics of the pathogens in ventilator-associated pneumonia (VAP) following severe craniocerebral trauma. METHODS The 220 cases with severe craniocerebral trauma were analyzed retrospectively. RESULTS The incident rate of VAP was 24% in these patients. A total of 169 pathogens were isolated,including 146 ( 86%) strains of bacteria and 23 (14%) fungal isolates. The main Gram-negative bacteria (114 strains) were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,etc. The Gram-positives (32 strains) were Staphylococcus aureus and twenty-four (75%) of them were meticillin-resistant. CONCLUSIONS The incident rate of VAP is high following severe craniocerebral trauma. Most of the isolated pathogens are drug resistant. These cases have mixed infection occurred commonly. To prevent and treat VAP,we should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.

Seven guaiane-type sesquiterpenoids, a new compound 6-formyl-5-isopropyl-3-hydroxymethyl-7-methyl-1H-indene (1), a new natural product 5-isopropyl-3, 7-dimethyl-1H-indene-1-one (2), along with five known compounds: guaiazulene (3), 4-formyl-7-isopropyl-10-methylazulene (4), sesquiterpene ketolactone (5), alismoxide (6) and guaia-1 (5), 6-diene (7), were isolated from gorgonian Muriceides collaris collected in South China Sea. Their structures were elucidated on the basis of extensive spectroscopic analysis [MS, IR, 1H NMR, 13C NMR (DEPT), HMQC, HMBC, NOESY] and by comparison of the spectral data with those of the literatures.

Objective To study the selective tumoricidal effect of adenovirus (Ad)-mediated fusion gene system driven by kinase domain-containing (KDR) promoter on human stomach adenocarcinoma SCG7901 cells, and to observe its apoptosis induction effect. Methods Both the AdEasy-KDR-CDglyTK cells with KDR-expressing SCG7901 cells and non KDR-expressing HepG2 cells were reconstructed, and then they were treated with the pro-drugs 5-FC and/or GCV at different concentrations. The killing effects of the transfection on the cells were evaluated. Flow cytometry was employed to determine the cell cycle distribution, and Hooechest/PI stain and electron microscopy performed to observe the pathological changes of cells. Results The green fluorescent protein (GFP) was observed in 95% of the infected SCG7901 and HepG2 cells when the multiple of infection (MOI) of the Ads was 100. No significant difference on the growth feature was found among the transfected SCG7901, HepG2 and untransfected SCG7901 and HepG2 cells. The infected cells exhibited different sensitivities to the two pro-drugs: SCG7901 cells infected with rAd were highly sensitive to the pro-drugs, while the infected HepG2 cells were not (P