0.05);the preoperative use rate was 8.6% and 65.1%(P0.05);both groups used drug mainly in vein and in single mode.CONCLUSIONS After the implementation of the Guideline the rational use of antibiotics is improved but there are some problems needed to manage further.

Objective To investigate the expression of proliferating cell nuclear antigen (Ki67) in hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) tissue and its correlation with clinicopathological parameters of HBV related HCC. Methods HBV-related HCC patients (n=134) were divided according to Ki67 index (the percentage of Ki67-posi?tive cells) into Ki67 index<10%group (negative group, n=30) and Ki67 index≥10%group(positive group, n=104). The cor?relation of Ki67 index with age, gender, glypican 3 (GPC3), histological grade, BCLC (Barcelona Clinic liver cancer) staging, portal involvement, AFP (AFP), liver function related child-pugh classification data were calculated in both groups. Ki 67 in?dex is set according to the interval score to assess the relationship between Ki67 score and BCLC classification. Results (1) SP staining showed, Ki67 present a trend of increase from normal liver tissue to well-differentiated to medium differentiat?ed tissue to poorly differentiated tissues intensity. (2) In positive group, Ki67 index was correlated with BCLC staging, portal metastasis, histological grade, GPC3 and AFP (P<0.05);By contrast, in negative group, Ki67 index was not correlated with any clinical parameter (P>0.05). (3) Ki67 score increases with the progress of BCLC classification. Conclusion In Ki67 positive group, Ki67 index combined with GPC3, histological grade, BCLC staging, portal involvement, AFP and liver func?tion child-pugh classification can assess the severity of the patients with HCC, which is expected to become an important in?dicator for the HBV-related HCC early diagnosis.

Clinical tutors' personality manifesting during the process of clinical practice and daily communication with medical interns has a series of influences on medical ethics formation of medical interns,including influences of direction,demonstration,contraction,and halo effect.Thus,clinical tutors should pay attention to cultivating a decent moral personality,and hospitals should value the proper combination of moral evaluation and supervision for medical staff in order to achieve the unity of heteronomous morality and self discipline,and effectively promote the formation of decent morality and personality of clinical tutors.

Objective To evaluate the effects of propofol on TREM-1 expression in THP-1 cells stimulated by lipo-polysaccharide (LPS). Methods Cells were divided into 7 groups: (1) control group; (2) LPS group that was exposed to LPS in final concentration of 100μg/L;(3) Progroup that was incubated with 100μmol/L propofol;(4-7) groups combined 100μg/L LPS with propofol at different dose of 12.5μmol/L (P1 group), 25μmol/L (P2 group), 50μmol/L (P3 group), 100μmol/L (P4 group) respectively. After 16 hours of incubation, the TNF-α concentration in supernatants were measured by ELISA. TREM-1 expression were examined by FACS and TREM-1 mRNA were detected using qRT-PCR. Results TREM-1 on THP-1 increased significantly in group P3 and group P4 compared with LPS group (P<0.05). The concentra-tions of TNF-αin P3 and P4 (P<0.05) decreased substantially in supernatant compared with LPS group. TREM-1 mRNA transcription level in group LPS rise considerably (P < 0.05) compared to that in control group, and it dropped greatly in group P4 (P <0.05) compared with that in group LPS. Conclusion Propofol could enhance TREM-1 expression on sur-face of THP-1 stimulated by LPS. Propofol reduces TNF-αlevel in culture supernatant. And propofol may restrain TREM-1 mRNA expression.

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

Objective To explore the methods of inducing human placenta mesenchymal stem cells (MSCs) to differentiate into insulin-producing cells. Methods MSCs were obtained from human placenta and were induced to differentiate into insulin-producing cells by activin A, epidermal growth factor (EGF), basic fibroblast growth factor (bFGF) and other cytokines. The cells were identified by immunocytochemistry staining, Western Blot and animal experiment after differentiation. Results After induction, the cells possessed some characteristics of islet βcells, and could express pancreatic duodenal homeobox-1 (PDX-1), insulin and C peptide. The induced cells could also decrease blood glucose levels of diabetic mice. Conclusions These results showed that human placenta MSCs can be induced to differentiate into insulin-producing cells by cytokines.

Objective:To investigate the feasibility of adipose tissue-derived stem cells(ADSCs) as the seeding cells of skin engineering for skin defect repair. Methods :Adipose tissues were isolated from a SD rat groin, the fat was cut and incubated in a collagenase solution, and then the ADSCs were cultivated in culture medium. The amplified cells in vitro were inoculated in collagen gel to form tissue engineered skin. Fifteen SD rats were randomly divided into three groups: experimental group was treated with ADSCs collagen tissue engineered active skin substitute, and single collagen and blank were served as two control groups. The materials were grafted onto total skin defect wounds on the back of rats in the corresponding group respectively. The effect of wound repair was observed histologically. Results:The time of wound healing in the ADSCs and collagen experimental group, the single collagen control group and the blank control group were (14.3?1.7) days,(16.9?2.5)days,and (21.2?4.2)days respectively, and showed significant differences(P

Objective To study the clinical results and safty of photodynamic therapy (PDT) after single and multi treatments of patients with subfoveal choroidal neovascularization (CNV) caused by wet age related macular degeneration (AMD). Methods From July, 2000 to July, 2001, 20 wet AMD patients (31 eyes) 47 88 years old (mean 68.2 years old) with best corrected visual acuity from FC/10 cm to 0.6 diagnosed through optic coherence tomography (OCT), fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were treated with PDT. All cases were assigned to benzoporphyrin derivative mono acid (BPD) (6 mg per square meter of body surface area), administered via intravenous infusion of 30 ml over 10 minutes. Fifteen minutes after the start of the infusion, a laser light at 689 nm (Zeiss company, German) delivered 50 J/cm 2 at an intensity of 600 mW/cm 2 over 83 seconds on CNV. Visual acuity, photochrome of ocular fundus, OCT, FFA, ICGA were used to evaluate the effects of photodynamic therapy with BPD. Follow up of these patients was planned 1 2 week and every 3 month after PDT. Once the lesion area progressed, PDT was applied again. Tweenty cases (31 eyes) were followed up from 3 to 18 months (average 12 month).In 1 affected eye, PDT was applied fow 4 times, 4 eye for 2 times, and the other 26 eyes for 1 time. Results The visual acuity in 13 (41 9%) eyes was improved ( increase≥2 lines) after PDT. Stabilized (?1 line) in 17 (54 8%) eyes and decreased 2 lines (attributed to the recur of CNV ) in 1 (3 2%) eye. After PDT, the fundus haemorrhage and fluid leakage reduced. FFA and ICGA showed. cessation and obvious reduction of fluorescein leakage from CNV in all patients 2 weeks after photodynamic therapy, and retreatment decreased the leakage step by step. Fluorescein leakage from at least a portion of the CNV reappeared by 1 3 month after treatment in some cases. OCT also showed the reduction of the size of CNV, moreover, the edema of surrounding retina and choriodal and serous neural epithelial detachment recovered obviously. No side affect during and after PDT was noticed. Conclusions PDT with BPD can achieve short term effect on part or total cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in patients with age related macular degeneration, retreatment of PDT was also effective.

Objective To summarize the clinical results and safety of photodynamic therapy (PDT) through 4 years after single and multi-treatments of patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods Clinical data of 73 AMD cases (95 eyes) diagnosed through fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT), treated with PDT were reviewed and analyzed in this hospital from June 2000 to June 2004. The changes of best corrected visual acuity (BCVA), fundus pictures, FFA, ICGA and OCT were compared before and after PDT. Follow-up time varied from 3 months to 4 years (mean, 2 years). Results The mean age of 73 patients was 67.8 years old. The BCVA was from (CF/10 cm) to 1.0. At the final follow up, the BCVA was improved (increase≥2 lines) in 39 eyes (41.1%), stabilized (?1 line) in 51 eyes (53.7%) and decreased 2 lines in 5 eyes (5.3%). Fundus hemorrhage and exudation reduced after PDT. FFA and ICGA showed CNV complete closure in 58 eyes (61.05%), partial closure in 6 eyes (6.32%), CNV incomplete closure in 22 eyes (23.16%) and recurrence in 9 eyes (9.47%). After once PDT of 12 eyes with early-stage AMD, the BCVA improved (from 0.6 to 1.5), CNV completely closed, and the OCT showed disappearance of macular edema and neursensory retinal detachment. No CNV recurred in our four years follow-up observation and the BCVA of the patients remained stable. The mean number of PDT treatment was 1.8 per eye in 95 cases. No serious local or systemic complications were encountered. Conclusions Single or multiple sessions of PDT can acheive long-term safety and efficacy. For early-stage AMD patients with minimally classic CNV, PDT can completely make CNV closed and reduce the risk of visual loss.

Objects To observe whether mesenchymal stem cells exist in umbilical cord blood and if they can differentiate into osteoblasts and adipocytes.Methods Nucleated cells were separated with Hespan,Mesenchymal-like stem cells were identified by surface marker with flow cytometry.Osteoblast was identified by von Kossa staining and alkaline phosphatase staining,adipocyte was identified by Oil Red O staining.Results From the Nucleated fraction of UCB,we demonstrated the presence of a subset of cells that express adhesion molecules CD13+,CD29+,and CD44+,but not antigens of hematopoietic CD34,CD45,CD14 and neither antigens of endothelia CD106.Exposure of these cells to osteogenic inductive agents resulted in an increase in the expression of alkaline phosphatase and the appearance of hydroxyapatite nodules by Von Kossa staining.Incubation with adipogenic inductive agents resulted in morphological change and positive staining with oil Red O.Conclusions Mesenchymal-like stem cells exist in cord blood and have a lower precursor frequency.The cells can differentiate into osteoblast and adipocyte.Cord blood may function as a new source of cells for cellular therapeutics.