OBJECTIVETo investigate the reproducibility of Gleason scores for prostate cancer.

METHODSBased on the revised Gleason Scoring System of the International Society of Urological Pathology ( ISUP) , we analyzed the reproducibility and difference of Gleason scores in 49 cases of prostate cancer using the methods of combination and grouping.

RESULTSThe total reproducibility of Gleason scores among 15 pathologists was good (κ = 0.642), 62.2% by the combination method, the highest in Gleason 5 + 5 (81.2%) and 5 +4 (73.3%), then in Gleason 4 + 4 (67.5%), 3 + 3 (64.0%), 4 +3 (61.3%), and 3 + 4 (44.0%), and the lowest in Gleason 4 + 5 (38.9%) and 3 + 5 (33.3%). The total reproducibility of Gleason scores by the grouping method was 71.4%, the highest in Gleason 9-10 (84.9%) , then in Gleason 7 (76.7%) and 6 (64.0%), and the lowest in Gleason 8 (60.7%).

CONCLUSIONThe reproducibility of Gleason scores remains to be further improved in prostate cancer, mainly concerning the understanding of Gleason 3 and 4 carcinoma.

Cholesterol ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Metabolic Diseases ; prevention & control ; Phytotherapy

Objective Establishment and characterization of healthy donor's ??T cell clones.Methods ??T cells were cloned by limiting dilution after positive sorting with 60Co irradiated allogeneic PBMC as feeder cells.Flow cytometry analysis and molecular biology technique were then used to identify ??T cell clones.MTT assay was used to verify their proliferation after incubated with epitope peptides recognized by ??T cells.Results A ??T cell clone had been established.The subtype of this clone was V ?9 V ?2 without expression of CD4 and CD8.Further studies indicated that epitope peptide EP6 could not only specifically bind to ??T cell clone but also trigger the proliferation of ??T cell clone.Conclusion A healthy donor's ??T cell clone was successfully established,which laid a solid foundation for further study on ??T cells.

Objective To investigate in evaluation of various capacity requirement of probationer nurs-ing students by nurses in operation room in order to improve clinical teaching work. Methods A self-de-signed questionnaire was applied, 191 qualified teaching nurses from nine grade three A general hospitals in Beijing were invited to fdl the questionaires. The results underwent subsequent analysis. Results The teach-ers had high expectations for various capacity of the probationer nursing students. Conclusions Clinical teachers should establish feasible teaching scheme according to the existing teaching syllabus in order to in-crease teaching quality, make students gain new insights through reviewing old materials, so that they can mas-ter various technique in operation room in short time.

Data is the basis and soul of clinical trials. To obtain accurate data, strict and standard data management is essential, which can be effectively supported by quality control in statistical analysis. In this paper, we briefly introduce the concept of the quality control in clinical trials, and describe its contents and methods. We hope that this work will be helpful to the application of statistical quality control in data management of clinical trials.
Clinical Trials as Topic ; standards ; Data Collection ; standards ; Quality Control ; Statistics as Topic

Clinical data of 27 children with renal calculi (11 cases on the right side and 16 on left)who were treated with extracorporeal shockwave lithotripsy (ESWL) using HB-ESWL-VG lithotripter from April 2006 to October 2008 were retrospectively reviewed.The size of stones ranged from 5 mm to 17 mm in diameter (mean 11 mm).In 22 out of 27 cases (82%) stones were crushed completely after the first course.Eleven of 27 ESWL cases were stone-free in 7 days,8 patients in a month after treatment;the stonefree rate was 96% when patients were followed up for 1 year.The results suggest that ESWL is a safe and effective method for treatment of renal calculi in children.

Objective To study change of the declarative memory in patients with the calcification of the pallidum.Method The Chinese version of Wechsler Memory Scale(WMS-RC)test and dmwing forgetting curve were applied in 30 patients and 30 normal controls.Results There was no differences in the WMS-CR test's scores between the two groups.The patients had poorly memory preservation rate at the delays of 2 hours((64.10±0.87)%Vs(44.83±1.57)%,P<0.01),despite normal memory preservation rate over 30 mins and the similar slope after the delays of l day in the forgetting curve.There were negative correlations between the size of calcification and the memory preservation rate at the delays of 2 hours and 9 hours(r=-0.743,r=-0.483.P<0.01).Conclusion The results may reflect the effect of the pallidum on"slower confiolidation"declamtive memory process which aroused by a consequence of the repeated firing of hippocampal-neocortieal connections while the patients have normal memory encoding and retrieval.

Objective To evaluate the teaching effect of seminar method in clinical teaching of department of urinary surgery.Methods A total of 30 clinical medical students were randomly divided into two equal groups:test group with seminar teaching method and control group with traditional teaching method.Results Were evaluated by scores of theoretic test,operating skill and survey after 3 months.Results Scores of theoretic test and operating skill in test group were significantly higher than those in control group(P ＜0.05).There were significant differences in scores of survey between two groups(P ＜ 0.05).Conclusions Seminar teaching method could effectively improve student learning initiatives and teaching effect,and is worth further exploration.

Objective To evaluate remedy therapy for biliary restenosis after repair of bile duct injury.Methods Clinical data of 60 patients with bile duct injury including 16 patients with restenosis after repair admitted to Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2000 to December 2012 was retrospectively analyzed.Results 16 patients suffering from biliary duct restenosis included 3 cases of type Ⅱ 1 d,10 cases of type Ⅱ2 d,2 cases of type Ⅱ 3 d and 1 case of type Ⅱ 4 d.The reoperative procedures included hepatic hilar biliary plasty with bilioenteric anastomosis in 15 cases,right hemihepatectomy with left hepatic bilioenteric anastomosis in 1 case.Postoperative bile leakage in 3 cases and pleural effusion in 10 cases were cured by watchful therapy.All of the 16 cases were followed up with an average time of 5.2 years.No occurrence of cholangitis and elevated liver enzymes were observed up to now in 8 patients,increased γ-GT and ALP,no cholangitis but anastomotic stenosis as showed by MRCP in 6 patients with 2 patients neccesitating reoperation to address repeated cholangitis.Conclusions Restenosis after bile duct repair was closely associated with injury type,repair opportunity,repair methods and the surgeon's expertise.Precise preoperative evaluation,the choice of rational surgical approach,the clinging to mucosa-to-mucosa bilioenteric anastmosis principle and the establishment of postoperative long-term followup system centered on ALP,γ-GT and life quality score are required in the reoperation of stenosis after bile duct repair.

Objective To optimize in vitro amplification of human γδ T cells with cytokines for tumor adoptive immunotherapy.Methods On the basis of the immobilized anti-TCR γδ antibody plus IL-2 system, other γ chain receptor family cytokines, including IL-7, IL-15 and IL-21, were tested to amplify human peripheral blood γδ T cells either alone or in diversity combination.The percentage of γδ T cells was measured by flow cytometry, and the proliferation efficiency of γδ T cells was calculated.The expression of proliferation-or cytotoxicity-related molecules on γδ T cells was examined by flow cytometry in order to explore the relevant mechanisms.The cytotoxicity of γδ T cells to Daudi cells was detected by lactate dehydrogenase.Results IL-15 alone but not IL-7 or IL-21 increases the γδ T cell purity, amplification efficiency and cytotoxicity to reach comparable levels to those of IL-2.IL-2 plus IL-15 up-regulates the expression of CD69 on γδ T cells and significantly increases their amplificationefficiency (P<0.05).IL-2 plus IL-21 enhanced the cytotoxicity of γδ T cells against Daudi cells by increasing the expression of granzyme A (P<0.001).The combination of IL-2, IL-15 and IL-21 significantly improves cytotoxicity of γδ T cells but reduces their amplification efficiency.In addition, when IL-21 was applied for a short time, it also enhanced the cytotoxicity of γδ T cells (P<0.05).Conclusions The combination of IL-2 and IL-15 as well as a short time addition of IL-21 is the best cytokine recipe to amplify human peripheral blood γδ T cells in vitro with immobilized anti-TCR γδ antibody, which can increase both the proliferation efficiency and the cytotoxicity to tumor cells of γδ T cells.