ObjectiveTo provide experimental proof for the specific immunotherapy in patients with renal cell carcinoma (RCC).MethodsThe expression of c-erbB-2 and HLA-A2 molecules in RCC were examined by flow cytometery and HLA-A2 cDNA RT-PCR.Tumor lysatic antigens (Tuly) was used to load DCs (DC-Tuly) to induce the generation of c-erbB-2 specific CTLs derived from peripheral blood mononuclear cells of RCC patients in vitro and CTLs was used to kill RCC cells which express or not express c-erbB-2 and HLA-A2.The cytotoxic activity of induced CTLs was further studied by antibodies (anti-c-erbB-2 and anti-CD 8) blocking assay.Resultsc-erbB-2 protein is tumor associated antigens for RCC.DC-Tuly induced specific CTLs highly killed c-erbB-2+ HLA-A2+ autologous and allogenic RCC,but non-specific ones lowly killed c-erbB-2- HLA-A2+ or c-erbB-2+ HLA-A2-RCC cells. The cytotoxic activity against tumor cells was blocked by anti-c-erbB-2 and anti-CD 8 monoclonal antibodies.ConclusionsThese results suggest that this specific CTLs adoptive immunotherapy for RCC patients with c-erbB-2+ HLA-A2+ could be a novel approach for clinical use.

Objective To investigate the Preventive effect of sodium hyaluronate gel on postoperative adhesion of hysteroscopic intrauterine adhesions. Methods 84 cases of IUA patients undergoing hysteroscopy were retrospectively selected,and divided into two groups according to the different ways of prevention and control of IUA,42 cases in each group.The control group was treated with Foley balloon catheter after operation,the study group was treated with sodium hyaluronate gel prevention on the based of control group.The clinical signs of the patients before and after treatment one,two and three months were observed,the therapeutic effects and complication were compared between two groups. Results After treatment one,two and three months,the adhesion type score and the score scale of study group, were significantly decreased,and lower than the control group,the difference was statistically significant (P<0.05).The total effective rate of the study group was 90.48%,which was significantly higher than that of the control group (83.33%),the difference was statistically significant (P<0.05).In the course of treatment,the complication rate of the two groups was 11.90% (5/42),there was no significant difference between the two groups in the incidence of complications. Conclusion Hyaluronic acid sodium gel on hysteroscopic intrauterine adhesions in patients with postoperative adhesions have a significant preventive effect,can improve the treatment efficiency and clinical signs,and with high security.

OBJECTIVE: To confirm the feasibility of target-controlled infusion of midazolam on conscious sedation for patients undergoing combined spinalepidural anesthesia and the needed target-controlled blood concentration.METHODS: Sixty patients undergoing combined spinal-epidural anesthesia were subjected to target-controlled infusion of midazolam.The level of sedation of midazolam was evaluated applying OAA/S score and bispectral index(BIS).The correlation between target-controlled blood concentration(Cp) and BIS was determined.The Cp,BIS,MAP,HR and SpO2 at different OAA/S were observed. RESULTS: When OAA/S score was 3,the required target-controlled blood concentration of midazolam was(122.8? 20.8) ng? mL-1 in midazolam sedation patients.There was a good correction between BIS and Cp,and BIS=— 3.28Cp+ 355.22(r=— 0.862 5,P

Objective To make use of the characteristics of presenting and processing tumor antigen of dendritic cells to enhance killing capability of CTLs against autologous renal cell carcinoma. Methods Autologous dendritic cells were obtained by culturing bone marrow cell from patient with RCC in the presence of granulocyte macrophage colony stimulating factor(GM CSF) and IL 4. Dendritic cells were loaded with tumor cell lysate and co cultured with autologous PBMCs from patient to induce generation of tumor specific cytotoxic T cells(CTL). Killing activity and cytokine release of the CTL and the population of CTL were measured by cytotoxic assay and ELISA and FACS analyses. Results Immune response of DC Tuly induced CTL was demonstrated by the following facts:(1)the growth expansion of CTL enhanced 43 folds on day 16;(2)up regulation of the CD3 + and CD8 + population in CTL;(3)the cytotoxicity of specific CTL against autologous RCC was highly enhanced as compared with allogenic RCC and heterogenous tumor( P

Objective To establish human renal cell carcinoma (RCC) cell lines,and to investigate the cell phenotypes and expression of tumor associated antigens. Methods Fresh tumor tissues from pathologically proven human RCCs were primary cultured and passed generation to generation until a stably grow in vitro.The cell cloning form,chromosome and graft into nude mice in vivo were examined for cell lines.Immunofluorescent stain and flow cytometric analysis were carried out for cell's phenotype,RT PCR examination for MN/CA9 gene expression. Results Six human RCC cell lines have been established,including four of the cell lines derived from clear cells,one from mixed clear granular cells and one from papillary cells.All the cell lines showed the characteristics of malignant cells.All the lines highly expressed HLA ClassⅠ and HER2/neu.Three lines weakly expressed HLA ClassⅡ and one cell line highly expressed CD86 but all the lines did not express CD80.RT PCR showed that three cell lines have the expression of MN/CA9 gene. Conclusions These newly established RCC cell lines would provide a useful in vitro model for studies related to biological characteristics,tumor associated antigen,immunogenity and immunotherapy of human RCC.

Objective To explore the clinical effectiveness of the platelet parameter in neonatal hypoxic-ischemic encephalopathy(HIE).Methods From Oct,1999 to May 2001,50 cases of neonatal HIE were final diagnosed,the platelet total(PLT),mean platelet volume(MPV) and platelet distribution width(PDW) were dynamic observed.It was compared with 27 cases of normal term infant.Results ⑴PLT in acute period of HIE was obviously lower than that of the normal term infant(P0 05).⑵The PLT in the HIE was decreased(P

Objective To explore the current situation of knowledge,beliefs and behavior of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,14 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes and corresponding subthemes sublimated from the patients:self-management knowledge and skills,self-management beliefs and attitudes and self-management behavior.Conclusions It is necessary to pay close attention to spreading disease related health information,especially for patients with low health literacy.During the process of COPD self-management projects,we should focus on negative beliefs and negative attitudes on their selfmanagement behavior choice,which is as important as strengthening the patients' self-efficacy.

BACKGROUND: Whether a combination of the nano-hydroxyapatite (nHA) scaffolds with bone morphogenetic protein-2 (BMP-2) is superimposed to promote or inhibit the bone marrow stromal stem cells, as well as its biocompatibility, remain unclear.OBJECTIVE: To observe the biocompatibility and bone formation activity of nHA/BMP-2 co-cultured with rabbit bone marrow stem cells in vitro.METHODS: Bone marrow stem cells obtained from rabbits were cultured and proliferated in DMEM medium in vitro. The cells at the third passage were inoculated into four mediums and according divided into four groups: control group, BMP-2 group, nHa group, and nHa/BMP-2 group. RESULTS AND CONCLUSION: The cell diplo-proliferation time of control group and nHa group was longer than that in BMP-2 group and nHa/BMP-2 group. The cells proliferative activity calculated by MTT assay and bone formation activity based on the alkaline phosphatase method demonstrated statistical significant difference in BMP-2 group and nHa/BMP-2 group compared with control and nHa group (P < 0.01). Experimental findings indicate that, the tissue formation of nHA/BMP-2 not only has good biocompatibility with Bone marrow stem cells, but also could bring into full play the effect of BMP-2 for promoting the proliferation, differentiation, and bone formation activity of bone marrow stem cells.

Objective To investigate the effects of penehyclidine hydrochloride combined with ulinastatin on lung injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods Sixty ASA Ⅱ or Ⅲ patients of both sexes,aged 33-64,weighing 47-81 kg,NYHA class Ⅱ or Ⅲ ,scheduled for cardiac valve replacement,were randomly divided into 4 groups(n = 15 each): control group(group C),ulinastatin group(group U),penehyclidine hydrochloride group(group P)and penehyclidine hydrochloride + ulinastatin group(group PU).Group U,P and PU received iv injection of ulinastatin 20 000 U/kg,penehyclidine hydrochloride 0.05 mg/kg and ulinastatin 20 000 U/kg + penehyclidine hydrochloride 0.05 mg/kg 30 min after the end of CPB,respectively,while group C received equal volume of normal saline.Then PEEP was increased to 8 cm H2O in all groups.Blood samples were taken at 30 min,3 and 6 h after the end of CPB and 12 and 24 h after operation for determination of PaO2 and serum concentrations of TNF-α,IL-6,IL-8 and IL-10.Airway peak pressure and airway plateau pressure were recorded at the corresponding time points.Oxygen index(OI)and pulmonary compliance(CL)were calculated.Lung injury was scored at 6 h after the end of CPB and 12 and 24 h after operation.Results OI and CL were significantly increased and lung injury score was significantly decreased in group U,P and PU compared with group C(P ＜ 0.05 or 0.01),and in group PU compared with group U and P (P ＜ 0.05).Serum concentrations of TNF-α,IL-6 and IL-8 were significantly lower and the serum IL-10 concentration was significantly higher in group U,P and PU than in group C(P ＜ 0.05 or 0.01),and in group PU than in group U and P(P ＜ 0.05).There was no significant difference in the indices mentioned above between group U and P(P ＞ 0.05).Conclusion Penehyclidine hydrochloride combined with ulinastatin can attenuate lung injury by inhibiting inflammatory response in patients undergoing cardiac valve replacement with CPB.

Objective To explore the negative emotion and self-management of elderly patients with COPD during their community-based rehabilitation.Methods Phenomenological research method of qualitative research was used,12 elderly patients with COPD during their community-based rehabilitation period received in-depth interviews.Results There were three themes sublimated from the patients negative emotions:aloneness and inferiority feeling,self-abasement and guilty feeling,sense of helplessness.Self-management of negative emotions also had three themes:gratitude mood,complying with the disease and distracting attention.Conclusions It is necessary to pay close attention to the negative emotions of elderly patients with COPD during their community-based rehabilitation; the community healthcare services should bear the responsibility of COPD patients' rehabilitation; we should explore practical intervention plan work on gratitude mood of elderly patients with COPD ; mobilize all social resources to do a good job on social support in elderly patients with COPD.