Cytokine induced killer (CIK) cells are a new kind of cytotoxic cells,which are generated by stimulation of peripheral blood mononuclear cells (PBMC) with IFN-γ,IL-2,IL-1 and anti-CD3 in vitro.These cells represent phenotype of both T cell and NK cell and have advantages of the non MHC restriction,so they have a strong ability of antitumor activity in vivo and vitro.Now,CIK cells as the main effector cells of adoptive immunotherapy have been extensively used in a variety of solid tumors such as liver cancer,lung cancer and hematological malignancies including leukemia,lymphoma,myeloma.In this article,the optimized cultivation of CIK cells as well as their most prominent clinical application in hematologic malignancies were summarized.

Vascular injury is a severe complication when combined with biliary injuries in laparoscopic cholecystectomy. The most frequent injury is damage to the right branch of the hepatic artery. The incidence ranges between 6. 7% and 61.1%. When bile duct transection is combined with vascular injury, the clinical course is complicated by liver ischaemia or necrosis, biliary stricture, and liver lobar atrophy which sometimes necessitating liver resection or even transplantation. Reconstruction of vascular injury is helpful when the injury is identified early.

To investigate the cause of donor death in living donor liver transplantation(LDLT), we reviewed all published articles in English on LDLT from the Foreign Medical Journal Full-Text Service (FMJS) and searched the literature for donor deaths before 2008. We identified 12 donor deaths. The rate of donor death is 0.2%. Any donor death would be a catastrophe for the donor's family and for the medical team. It is imperative to avoid donor death in LDLT.

Objective To discuss the therapeutic method of extracranial athemsclerotic carotid artery stenosis . Methods A retrospective analysis was conducted in 51 patients with angiography confirmed carotid artery stenosis from January 2012 to June 2012 in our hospital.The carotid endarterectomy (CEA) was performed in 16 cases, while the carotid artery stenting (CAS) was performed in 35 cases. Results All the 51 operations were successfully completed .There were 1 case of transient ischemic attack ( TIA) 3 days after CEA operation , 1 case of postoperative stroke after CAS operation , and 1 case of carotid sinus pressure after CAS operation . The follow-up period of all the cases was 9-15 months, with an average of 13.6 months.Ultrasound review of the carotid artery found no restenosis. Conclusion According to medical information of the patients with extracranial carotid atherosclerotic stenosis , we tend to adopt the CAS treatment in patients with following situations: ①transient ischemic attack at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%;②mild than disabling stroke onset at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%; ③carotid artery stenosis ≥2 cm under neck vascular CTA and cerebral angiography .We tend to adopt CEA treatment in patients with following situations:①asymptomatic carotid stenosis with degree ≥70%;②symptomatic carotid stenosis with degree range from 50%to 69%;③asymptomatic carotid artery stenosis with degree <70%, but with instable situation of lesions under angiography or other examinations .

Applying the value, cost and delivery of Lean Management, with the point of view of hospital president, health bureau and personnel of the medical record(TMR) and statistics, to analyze the problems existed in present work mode of TMR and statistics, and help the personnel of TMR and statistics to change thinking style, to find a new way to embody oneself value, at the same time solve the orientation of the TMR and statistics in hospital administration.

Thyroid peroxidase (TPO) , originally described as thyroid microsomal antigen, is present on the apical surface of thyroid follicular cells and is an antigen involved in cell mediated cytotoxicity. TPO evokes high-affinity, IgG-class autoantibodies (TPOAbs) and TPO-specific T cells that are markers of thyroid infiltration or implicated in thyroid destruction, respectively. Enzyme-linked immunosorbent assay is used most frequently for TPOAb detection and quantification. The other conditions associated with TPOAbs include pernicious anemia, connective tissue disorders, diabetes, inflammatory bowel disease, mood disorders, and fertility-related problems such as miscarriage, infertility, in vitro fertilization failure, pre-term delivery, and postpartum thyroiditis. The detection of TPOAhs is recommended in the investigation of goitre, diagnosis of Graves' disease and Hashimoto's thyroiditis, and the prediction of risk of developing hypothyroidism during subclinical thyroid disease.

OBJECTIVE To discuss the cause of CABG infection and its controlling methodology. METHODS In order to conduct comparative analysis of 40 cases of CABG incision infection and 40 cases of CABG without infection,the "rank sum test" statistical models were applied. RESULTS According to the analysis of statistics,the hospitalized days and costs in sample group with infection were higher than that of control group,and the difference had statistical significance.Compared with the control group,the hospitalized days of sample group with infection averagely increased 43.03 days(2.85 times),and the total hospitalized costs of it averagely increased RMB 84 314.38 yuan(2.02 times). CONCLUSIONS Apart from patients themselves,there are also many possibilities which will cause the infection,which request the on-going works on surgery skills improvement,standardizing the process of aseptic technique,disinfection and isolation,utilizing antimicrobial agents rationally,reducing patients′ hospitalized days before surgery,as well as improving the pre-operative management etc.

Objective To study the effects of dendritic cells (DC) modified with transforming growth factor ?1 (TGF-?1) gene on experimental autoimmune myasthenia gravis (EAMG) in Lewis rats. Methods 30 female Lewis rats were divided randomly into 6 groups: normal group, EAMG group, DCs treatment group, pcDNA_3-TGF-?1-DCs treatment group, pcDNA_3-DCs treatment group and normal saline group. The rats were immunized with the acetylcholine receptor (AChR) protein extracted from electric organ of Narcine timilei and completed Freund’s adjuvant (CFA) in the experiment groups except normal group. 2?106 pcDNA_3-TGF-?1-DCs/rat were injected subcutaneously into the backs of the rats that had been immunized 5 days earlier with AChR+CFA. The rats in DCs treatment group, pcDNA_3-DCs treatment group and normal saline group were injected in parallel with untreated DCs, pcDNA_3-DCs and normal saline respectively. Then the clinical manifestations were observed everyday. And 7 weeks after the first immunization, repetitive nerve stimulation, detection of acetylcholine receptor antibody (AChRab) and ultrastructural study of neuromuscular junction (NMJ) were performed. Results (1) The mild symptoms were observed on 1 or 2 rats in the experiment groups except normal group after a week, which lasted for 2 to 5 days. After about 5 weeks, the rats in EAMG group, DCs treatment group, pcDNA_3-DCs treatment group and normal saline group presented some symptoms at different degree like myasthenia gravis, and only one of the rats in pcDNA_3-TGF-?1-DCs treatment group presented mildly decreased activity. (2) The significant decrement of repetitive nerve stimulation were found in EAMG group, DCs treatment group, pcDNA_3-DCs treatment group and normal saline group(16.75?6.13, 17.75?7.81, 18.25?8.22 and 16.50?7.14, respectively), but there was no attenuation in pcDNA_3-TGF-?1-DCs treatment group and normal group(3.20?3.70 and 5.60?2.70, respectively). The percentage of decrement in pcDNA_3-TGF-?1-DCs treatment group was lower than that in EAMG group(5.60?2.70 and 16.75?6.13, respectively,P0.05). (4) The combined AChRs in NMJ of the rats in pcDNA_3-TGF-?1-DCs group were higher than that in EAMG group, and the structure changes of the synapse were relieved.Conclusion It suggests that DCs, transfected with pcDNA_3-TGF-?1, when injected subcutaneously into Lewis rats with incipient EAMG, could inhibit the production of AChR-Ab, relieve the pathologic changes in NMJ and ameliorate the development of EAMG.

Objective To investigate the expressions of vascular endothelial growth factor-C (VEGF-C) and vascular endothelial growth factor-D (VEGF-D) and their relationship with lymph node metastasis in gastric cancer. Methods Eighty patients with gastric cancer had been admitted to our department from January 2005 to December 2005, including 48 with local lymph node metastasis and 32 without local lymph node metastasis. Ten specimens of normal gastric mucosa from patients with gastric ulcer were used as control. The expression of VEGF-C and VEGF-D in serum and tissues were detected. Results The senun levels of VEGF-C and VEGF-D in patients with gastric cancer were significantly higher than those in the control group (χ2= 8.39, P < 0.05). The positive rate of the VEGF-C expression in the sermn of patients with gastric cancer was influenced by the lymph node metastasis (χ2 = 7.01, P < 0.05). The positive rates of the expressions of VEGF-C and VEGF-D in the gastric cancer tissue were 53% (42/80) and 63% (50/80), which were significantly higher than those in the normal gastric mucosa (χ2 =6.44, 6.58, P <0.05). The positive rate of the VEGF-C expression in the tissue of patients with gastric cancer was influenced by the lymph node metastasis (χ2=11.25, P <0.05). Conclusions The expression of VEGF-C is closely related to lymph node metastasis of gastric cancer. The serum levels of VEGF-C can be used as biologic markers in detecting lymph node metastasis of gastric cancer preoperatively.

As requested by both central government and Guangdong provincial government on the reform to separate drug prescribing and dispensing,Shenzhen has introduced its 1 + 6 comprehensive program.Breaking through from the drug price addition system,the program stages such six measures as the health service payment system reform,the compensation system reform among public hospitals,reform of the competition mechanism between pharmaceutical distribution enterprises and hospital pharmacies,reform of drug procurement methods,investigation and punishment of commercial briberies in drug purchase,and enhanced supervision of public hospitals.The paper detailed these measures and explained these innovative practices.