Evidence based medicine is based on the high quality evidence from medical journals.In this paper,the progress of evidence based medicine(EBM)and its effects on clincal practice and research are introduced,and the necessary of carrying out editorial examination and appraisal on statistical problems in medical articles is discussed.

Objective　To summarize the experiences in caudate lobectomy in five cases of hepatic carcinoma.Methods　Five cases of primary liver caudate lobe cancer resected in the last five years were reviewed.Some problems including anatomy,the biological characteristics of the caudate lobe cancer,surgical approach,blocking of the liver blood supply were discussed.Results　One case died on the 11th postoperative day,the other four cases have been followed up for five years,two years and nine months,two years,one year and six months,respectively.They are all survived.Conclusion　Liver cancer located at the caudate lobe can be successfully resected as those located in other regions with a clear anatomy and a full exposure.

Photo images,as a useful visual aid,are frequently seen in medical journals.This paper discusses the importance of photo in medical papers.Problems with the photos are discussed,which includes absence of caption,the illegibility of the photos,the inferior contrasts,absence of the unusual changes,etc..Suggestions are given to improve photo effect so as to improve the quality of medical papers.

24 h) was the main cause of high emergent perioperative death rate. There was a rationale for prophylactic surgery.

Objective To investigate the role of recombinant adenovirus Ad-PD-L1 on immunotolerance induction in mouse pancreatic islet transplantation. Methods Full-length mouse PD-L1 cDNA linked with an internal ribosome entry site (IRES)-GFP cassette was subcloned into pShuttle-GFP-CMV( - ) shuttle plasmid. The product was cut by certain restriction endonuclease and ligate with pAdxsi vector. The adenovirus bone plasmid was transformed into DH5α competent bacteria. The positive clone was identified by restriction endonuclease digestion and further confirmed by sequencing. After linearization, the recombined adenovirus DNA was transfected into 293 cells by liposome for package and amplification, which was purified by CsC1 density gradient centrifugation. Streptozocin was injected i.p. into C57BL/6 (H-2b) mouse to induce diabetic model recipient. Recipients were randomly divided into three groups, Group A was the control. Group B and group C were injected of Ad-EGFP and Ad-PD-L1 through tail vein respectively 1 day before islet transplantation. 300 to 400 islets of DBA/2 (H-2d) were transplanted into the renal subcapsular space of the diabetic model recipient. The level of blood sugar and the graft survival time were monitored. Results Recombinant adenovirns Ad-PD-L1 have high efficiency expression of PD-L1 in recipient mouse. The survival time of grafts of Ad-PD-L1 group (27.63 ± 3. 51 ) d was significantly longer than that of the control ( 7. 85 ± 0. 33 ) d and Ad-EGFP group ( 7. 67 ± 0. 59 ) d ( P < 0. 01 ). Mixed lymphocyte response showed a specific decrease reaction of recipient lymphocyte toward donor lymphocytes. Conclusion Recombinant adenovirus Ad-PD-L1 was successfully constructed. In mouse pancreatic islet transplantation, it can suppresses the activation of recipient T lymphocyte through PD-1/PD-L1 co-stimulatory pathway, and significantly prolong the survival time of grafts.

0.05). Nine HLA-A2-restricted CTL epitopes of CT10 were found. Conclusion CT10 mRNA is expressed with a high percentage and specificity in hepatocellular carcinomas. The CT10 gene product is potential target for antigen-specific immunotherapy of hepatocellular carcinoma.

Objective To explore the possibility of immune therapy for hepatocellular carcinoma (HCC) with MAGE-3 antigen peptide (FLWGPRALV). Methods The expression of HLA-A2 in HCC patients were examined with microcytotoxicity assay .The mRNA of MAGE-3 genes in the tumor tissues were detected by RT-PCR, the CD8 positive T lympocytes were separated as effector cells with immunobeads from peripheral blood mononuclear cells (PBMCs) of those patients. The irradiated autologous CD8 negative PBMC were pulsed with MAGE-3 peptide as APC. Some effector cells were co-cultured with APC, and some not as the control. After 14 days′ culture with IL-2, the frequency of effector cells secreting IFN-? in response to MAGE-3 peptide were monitored by IFN-? secretion assay. The hepatocellular carcinoma cell line HLE was used as the target cells.ResultsNine HCC patients were HLA-A2 positive in 25 HCC patients, and 3 of them were MAGE-3 mRNA positive. After two weeks′ culture, the effector cells increased by 4-6 folds. The frequency of CD8 positive cells secreting IFN-? in response to MAGE-3 peptide was 22.0% in 3 MAGE-3 mRNA positive patients(n=3),and 0.5% in 6 negative patients( n=6) (?

ObjectiveTo study the effect of TGF-? 1 signal transduction blocked by antisense-Smad 4 gene on progression of experimental liver fibrosis of Kunming mice.MethodsWe transfered retrovirus-mediated antisense Smad 4cDNA into the CCl4/ethanol induced cirrhotic liver of Kunming mouse model to investigate the antisense-Smad 4 gene integration by Southern blot. The expression of Smad 4 in cirrhotic liver was observed by Northern blot, RT-PCR, and Western blot. The fibrotic degree of the livers among the three groups were compared.ResultsThe antisense-Smad 4 gene was confirmed to integrate into the liver of the retrovirus-treated mouse .In the non-treated cirrhotic liver, the expression of Smad 4 mRNA was significantly increased than normal liver, the antisense Smad 4 gene could decrease the expression of Smad 4. Compared with the non-treated liver, the fibrotic septa of the liver in the retrovirus-treated mouse were fewer,narrow, and incomplete,and their fibrotic degree of the treated-liver was reduced.ConclusionThese results indicate that antisense-Smad 4 gene can reduce the expression of Smad 4,inhibit the progression of liver fibrosis.

Objective To investigate the effect of Shenfu injection on ischemia reperfusion injury of rat liver graft. Methods Male SD rats were used as isogeneic orthotopic liver transplantation. Sixty rats were randomly divided into two groups(30 in each). The recipient received Shenfu injection intravenously immediately before the removal of the liver in SF group and normal saline of the same volume in control group. At 3、6 and 24h after the reperfusion blood and hepatic tissue were sampled for examination. Results The levels of superoxide dismutase (SOD) and nitric oxide (NO) in SF group significantly increased compared with those in control group(P

Objective To investigate the postoperative changes of serum proteins and immune responses in critical patients and the effect of recombinant human growth hormone(rhGH).Method 45 critical patients were divided randomly into rhGH group (15 cases) and control group (30 cases) after operation. Patients in rhGH group were given rhGH 8*!U/d,im for 7 days starting 48 hours post operation. Result The postoperative level of serum transferin,albumin and prealbumin decreased in all patients, and so did the activity of CD 3,CD 4 ,CD 8,NK and the ratio of CD 4/CD 8 .Serum prealbumin level increased significantly in rhGH group at day 4 and after ( P