Objective The aim of this study was to investigate the distribution and clinical significance of CD8+ T cells in bladder cancer tissues in situ.Methods Immunohistochemistry were used to examine the distribution of CD8+ T cells in bladder cancer tissues,which were obtained from January 2003 to December 2009 from 302 patients.Among all the patients,262 were male while 40 were female;mean age is 60 years;tumor size ≤ 3 cm was in 235 and tumor size ＞ 3 cm was in 67;Unifocal tumor was in 214 and multifocal tumors were in 88.Amount of tumor stage Ta-T1 was 212 and T2-T4 was 90.Sixteen patients have lymph node metastasis.Histological low grade was diagnosed in 175 and histological high grade was diagnosed in 127.According to the differences between anatomic structure and cellular composition,bladder tumor tissues can be classified to two localization patterns:(1) intratumoral regions,defined as tumor cell nests;(2) stromal regions,defined as stromal areas that lack direct contact with tumor cells.Therefore,we divided 302 bladder cancer patients into two groups based on the median frequency of intratumoral CD8+ T cells (median,3/× 400 high resolution) and stromal CD8+ T cells (median,37/× 400 high resolution),respectively.x2 analysis was used to evaluated the correlation between CD8+ T cell density and clinicalpathological variables.Kaplan-Meier analysis and Cox proportional hazards regression models were applied to estimate overall survival (OS).Results CD8+ T cells were predominantly located in the intratumoral regions (mean,14 ± 2/× 400 high resolution) rather than in associated stromal regions (mean,50 ± 3/× 400 high resolution,P ＜ 0.05).The density of intratumoral CD8+ T cells was inversely associated with age (P =0.026),tumor size (P ＜ 0.05) and tumor stage (P ＜ 0.05),and could represent a favorable prognostic predictor of OS (HR =0.427,P =0.003).However,the density of stromal CD8+ T cells was positively associated with age (P =0.004) and histological grade (P ＜ 0.01),and could represent an adverse prognostic predictor of OS (HR =2.206,P =0.009).Conclusions Our findings suggest that intratumoral/ stromal CD8+ T cells could potentially serve as favorable/ adverse prognostic markers for bladder cancer patients,respectively.

Objective To evaluate the efficacy of percutaneous vertebroplasty for treating the vertebral compression fractures and vertebral metastatic neoplasms, and to assess its clinical curative effects Methods Among 81 cases (47 men and 34 women; ages 35～84, mean age 61 2 years), 110 vertebrae with metastatic neoplasms (61 cases) or vertebral osteoporosis (20 cases) were infused with methacrylate guided by DSA Effect of the operations was observed closely after the procedures Results The procedures were successful in all the involved patients and no significant complications were noted clinically Among the 61 patients treated for malignancies, 58 showed marked pain relief and 3 moderate pain relief 20 patients with vertebral osteoporosis demonstrated complete pain relief The cement leakage observed on radiographs included slight leakage to the adjacent disc (6 of 110, 5 5%), the epidural fat (8 of 110, 7 3%), the perivertebral venous plexus (2 of 110, 1 8%), and the paravertebral soft tissues (2 of 110, 1 8%) Conclusion Percutaneous vertebroplasty can significantly relieve the pain in patients with osteoporotic fractures caused by the malignancies and the vertebral osteoporosis We suggest that slight PMM leaks, when not symptomatic, should not be considered as complications

The culture conditions of Saccharomyces cerevisiae sp.strain by 1.1 b were optimized for the production of D-(-)-mandelate dehydrogenase which is useful for the asymmetric bioreduction of benzoylformate to form D-(-)-mandelate.The optimum medium(per liter)consistes of 60 g peptone,30 g maltose, 0.5 g MgSO_4,0.01 g ZnSO_4,1.0 g KCl.After optimization of the culture medium,the enzyme production in shake flasks is enhanced from 2.56 to 20.21 U/L.The optimum fermentation conditions were determined as follows:medium volume 100 mL(i.e.,40%for a 250-mL shake flask),pH 6.5,inoculum size 10%,temperature 30℃,and cultivation time 25 h.

Objective: To observe the effects of Jinqi Jiangtang Tablet, a compound Chinese herbal medicine, on serum matrix metalloproteinase-9 (MMP-9) level and MMP-9 expression in peripheral blood monocytes of rats with streptozocin-induced diabetes. Methods: Thirty Wistar rats were randomly divided into 3 groups: control group, untreated group and Jinqi Jiangtang Tablet group. Diabetes in rats was induced by a single intraperitoneal injection of streptozocin (70mg/kg body weight). After model building, rats in the Jinqi Jiangtang Tablet group were administered with Jinqi Jiangtang tablets at a dose of 0.8 g/(kg·d) for 6 weeks and rats in the control group and the untreated group were treated with normal saline. After treatment, level of fasting serum glucose was detected by hexokinas method; serum MMP-9 level was tested by enzyme-linked immunosorbent assay; MMP-9 expression in peripheral blood monocytes was measured by reverse transcription-polymerase chain reaction and Western blot method. Results: After treatment, fasting serum glucose level in the Jinqi Jiangtang Tablet group was less than that in the untreated group (P<0.05). After modeling, the serum MMP-9 level of rats in the untreated group was (9.11±3.55) μg/L and that in Jinqi Jiangtang Tablet group was (8.97±3.07) μg/L, which were higher than that in the control group ((4.39±1.44) μg/L) (P<0.01). After gavage, the level of serum MMP-9 was lower in Jinqi Jiangtang Tablet group than in the untreated group (P<0.05). The expression of MMP-9 in peripheral blood monocytes in the untreated group was higher than that in the control group (P<0.05). The MMP-9 expression in peripheral blood monocytes of rats with diabetes was down-regulated by Jinqi Jiangtang Tablet (P<0.05). Conclusion: Jinqi Jiangtang Tablet can decrease the level of serum MMP-9 and down-regulate the MMP-9 expression in peripheral blood monocytes at both mRNA and protein levels in rats with diabetes.

Objective To explore the clinical curative effect of hollow screw internal fixation for the treatment of distal epiphyseal teenagers tibial fracture.Methods Thirty -nine cases of epiphyseal fractures of the distal tibia were treated in Shanghai Children′s Hospital between February 2005 and September 201 4.This study included 24 boys and 1 5 girls with the average age of 1 3.1 years (ranged 1 0.5 to 1 6.2 years old).Preoperative diagnosis was confirmed by the X -ray films or CT examination.All the cases were closed fractures and manipulative reduction all failed.Surgi-cal reduction was performed when plain radiographs showed the fracture gap of epiphysis board and articular surface were greater than 2 mm or after closed reduction.Under C -arm X -ray machine,ankle axial traction was performed initially.Anatomical reduction underwent according to the bone fracture type.The fractures were fixed with cannulated screws by percutaneous or open approach.Postoperative X -ray or CT confirmed anatomical reduction at articular sur-face and growth plate.All patients had been immobilized with short -leg cast for 4 -6 weeks.The ankle joint function and growth were evaluated by means of American Orthopaedic Foot and Ankle Society(AOFAS)Ankle Hindfoot Scale. Results All patients were followed up for 5 to 91 months with an average duration of 35 months.X -ray films showed that all fractures were bone healing.No uneven articular surface was found and there was no extremity rotation and shorte-ning deformity.Results were evaluated by AOFAS scoring system:excellent in 27 cases,good in 10 cases,and general in 2 cases.All patients were able to participate in the normal physical activities.Conclusions CT with multiplanar recon-struction is a premise to make an accurate diagnosis and to choose a reasonable approach.For failed closed reduction for adolescent distal tibial epiphyseal fractures,the cannulated screws are simple and may have a satisfactory effect.

Objective To explore the diagnosis value of CT-guide percutaneous biopsy in the pulmonary nodules.Methods A total of 101 cases of the pulmonary nodules with unknown causes who underwent Germany-made auto-spring-gun spiral CT-guide percutaneous pulmonary biopsy were studied.Results The accuracy of centesis was 100%.97 cases were succeeded in getting diagnosis,the diagnosis rate was 96.0%.Among them,there were 61 cases of lung cancer,4 cases of malignant pleural mesothelioma,10 cases of metastatic carcinoma,16 cases of tuberculosis,6 cases of inflammatory pseudotumor.Pneumothorax occurred in 8 cases,hemoptysis occurred in 3 cases.The rate of complication was 10.9%.Conclusion CT-guide percutaneous biopsy to the pulmonary nodules is a safe and effective diagnostic means,which has a high diagnosis raze with few complication.

BACKGROUND: Cicatricial alopecia always occurs following the scalp trauma, and the optimal repairing method is scalp soft tissue expansion. OBJECTIVE: To verify the repairing effect of scalp soft tissue expansion therapy on the large-scale cicatricial alopecia. DESIGN, TIME AND SETTING: A case report was carried out in the Department of Burn and Plastic Surgery at the 180 Hospital of Chinese PLA (Quangzhou, Fujian, China) between January 1996 and April 2008. PARTICIPANTS: Thirty-six patients of cicatricial alopecia were adopted, with the size arranging 15 cm?9 cm to 24 cm?14 cm. METHODS: Scalp soft tissue expansion was performed in 36 cases of cicatricial alopecia. In later stage, the residual alopecia with small area was removed by scar excision plus suture for several times, treated with transposition repair of local flap and autologous hair transplant carrying hair follicle. The largest area to repair alopecia reached 336 cm2. MAIN OUTCOME MEASURES: Postoperative complications, repairing effect and cicatrix restitution were observed after operation; The elimination of alopecia area, hair density and appearance were detected during follow-ups. RESULTS: Psilotic scar eliminated in all cases, but 11 cases underwent scalp scar excision, transposition of local flap and autologous hair transplant because of wide incisional scar or residual small alopecia. No obvious complications occurred. It was found by a postoperative follow-up of 1-3 years that hair growth was good. CONCLUSION: Skin soft tissue expansion is an ideal method to repair cicatricial alopecia with large area. In later stage, the combination of simple repair methods can obtain better curative effect.

Objective To evaluate the left ventricular diastolic dysfunction by tissue Doppler imaging (TDI)in a suprarenal abdominal aortic coarctation model of Lewis rats. Methods Thirty male Lewis rats at age of 8 weeks were used. Myocardial hypertrophy model was obtained by suprarenal abdominal aorta banding with ligation. Mitral annular velocity measurement by TDI and regular two-dimensional echocardiography with M mode were examined at baseline and at 10-,20-,30-and 40-day post banding.Results Compared with baseline,the left ventricular end diastolic and end systolic wall thickness and ventricular dimension were progressively increased,while ejection fraction(EF)and fraction shortening(FS)were decreased(P＜0.0 1).The left ventricle demonstrated centrifugal myocardial hypertrophy.Peak myocardial systolic velocity(Sa)at the mitral annulus did not change significantly throughout this study and there was no significant correlation with EF(r=0.216,P=0.071),and peak myocardial early diastolic (Ea),late diastolic(Aa)at the mitral annulus and Ea/Aa indices also were not stable after aortic banding and there were no significant difference in repeated measures at different time(P＞0.05).But the E/Ea wasincreased and the index had a statistically significant difference(P＜0.001).Conclusions The left ventricleshowed centrifugal myocardial hypertrophy in Lewis rats with abdominal aortic banding.E/Ea radio was a sensitive and stable index to evaluate left ventricular diastolic dysfunction.

ObjectiveTo investigate the depression and anxiety state of heart transplantation patients. MethodsFifty-weight heart transplantation outpatients were assessed by Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) in Zhongshan Hospital during October 2010 to April 2011.Those diagnosed with depression disorder should meet the criteria of depression in Chinese Classification of Mental Disorder-3nd version (CCMD-3) and the score of HAMD≥14,and those diagnosed with anxiety disorder should meet the criteria of anxiety disorder CCMD-3 and the score of HAMA≥ 14.The diagnoses of concurrent depression and anxiety were made.Results The prevalence of depression disorder and anxiety disorder was respectively 15.5％ (9/58) and 22.5％ (13/58).The prevalence of depression disorder and anxiety disorder within 12 months was respectively 16.7％ (2/12) and 33.3％ (4/12).The score of HAMD was positively related to HAMA score (P＜0.01 ).ConclusionThe prevalence of depression disorder and anxiety disorder is very high and the co-existence of depression and anxiety is very common.