Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Objectives: The aim of the study was to evaluate the therapeutic effects of 6-mercaptopurine in the treatment of refractory childhood nephrotic syndrome (NS). Methods: According to the varieties of NS, 6-mercaptopurine (2 mg/kg body weight daily) combined with corticosteroid or 6-mercaptopurine (2 mg/kg body weight daily) alone after tapering of steroids were given to 28 consecutive children with primary NS in our hospital. Results: One month after the use of 6-mercaptopurine, proteinuria was decreased. The duration of improvement was 9～28 days, with mean duration of 17 days. Over-all effective rate was 85.7%. Among different varieties of NS, the best therapeutic effect was noted in steroid-dependent children; the better therapeutic effect in steroid-resistant children; and good therapeutic effect in frequently relapsing children. The effective rates were 100%, 84.6%, 81.8% respectively. All the pathological varieties of 28 children were confirmed by renal biopsy. The better therapeutic effects were noted in slight mesangial proliferative glomerulonephritis (MsPGN) and minimal change nephrotic syndrome (MCNS). The less therapeutic effect was noted in membranoproliferative glomerulonephritis (MPGN). Their therapeutic effective rates were 92.9%, 80%, 66.7% respectively. Unfortunately, drug-induced aplastic anemia was seen in 2 cases. Slight gastrointestinal reactions were present in 6 cases. There were no side reaction on the gonad. Conclusions: The great difference in the therapeutic effects is related to the different pathologic varieties of NS. With regard to the treatment of refractory NS in children, the pathological varieties should be confirmed by renal biopsy as soon as possible. Based on the renal biopsy, 6-mercaptopurine can be considered in the treatment of MsPGN and MCNS. As a result, relapses could be reduced; the duration of remission could be prolonged, and the side reactions from steroid treatment could be avoided. The use of 6-mercaptopurine for the treatment of refractory NS is one of the effective therapy.

Objective: Endoscopic measurement mainly depends on visual estimation or open biopsy forceps,which have been proved lacking in accuracy due to the image barrel distortion caused by wide-angle lens in endoscope.This study aimed to validate a new concept of "virtual internal standard" proposed by ourselves and develop a new method for endoscopic measurement based on the concept.Methods: We photographed planar grid graphs printed with standard calibrations with an electronic endoscope at different object distances,obtained the information on the virtual internal standard from each photo at the corresponding object distance,and analyzed the digital characteristics of the barrel distortion photos,including the size of the visual field,the image compression ratio,and the credible area for measurement with the virtual internal standard.Based on the analyses,the method of endoscopic measurement by the virtual internal standard was established and experiments both in vivo and in vitro were conducted.Results: The ratio of the object distance to the visual field was 1 ∶ 2 when the former was between 10 mm and 40 mm.Calculation of the compression ratio showed that the credible area of measurement in the central area was 10 mm at the object distance of 10-15 mm,20 mm at 20-30 mm,and 30 mm at 30-50 mm.The credible area of measurement on various planes accounted for 2/5 to 3/5 of the total image width.There was a tendency of double-curve change in the arrangement of pixel values of the central grids on different planes.The differences between the pixel values per centimeter became slight at the object distance of 35-50 mm.Conclusion: Endoscopic measurement by the virtual internal standard is a objective,accurate,simple and practical method.

Objective:Ischemic cerebral injury is a common complication during perioperative period.We found that ischemic postconditioning and various non-ischemic postconditioning(e.g.inhalation anesthetics) could significantly attenuate ischemic cerebral injury.The present study was to investigate the effect of Cyclosporin A on sevoflurane postconditioning in focal cerebral ischemia.Methods:Fifty male SD rats were randomly assigned to five groups (n=10 each): control group(con),1.0MAC group(sevo),1.0MAC+ Cyclosporin A group(sevo+CsA),1.0MAC+ vehicle group(sevo+vehicle)and Cyclosporin A group(CsA).All animals were subjected to right middle cerebral artery occlusion(MCAO) for 120min followed by reperfusion for 72h.The animals in sevo groups were given 1.0MAC sevoflurane inhalation from 20min before to 10min after reperfusion.The animals in CsA groups were given CsA by ICV injection before sevoflurane postconditioning.The neurological deficit scores(NDS) were recorded at 24h,48h,and 72h after reperfusion.Infarct volume percentage was determined after the last NDS assessment.Results:The infarct volume percentage ratio of Sevo, Sevo+CsA,CsA and Sevo+vehicle groups were 0.31?0.04,0.25?0.04,0.30?0.03 and 0.33?0.05,respectively(P

The readjustment of the army establishments has resulted in the mergence of some sanatoriums into hospitals,which has given rise to a novel mode of management and offered a new opportunity for the development of sanatoriums.In the past four years since the mergence of our sanatorium into Nanjing General Hospital in 2004,we explored the mode of integrating recuperation with treatment and combined the resource advantages of ours with the technical superiority of the hospital,which led to an improvement of our competitive ability and comprehensive service and accordingly promoted the overall development of the sanatorium.

To summarize the experiences of optimization of emergency medical care in Nanjing General Hospital.The principles and methods of optimizing emergency medical care were analyzed and summarized.The following methods were used to improve the emergency medical care: Applying modern conceptions of emergency medicine and establishing professional physician teams;Reinforcing the duty of each position and improving the quality of medical care;Modifying the mode and improving the working efficiency;Establishing clinical pathways for disasters and other accidents.The roles of emergency medicine are changed and modernized. Optimization of emergency care and popularization of emergency care skills may improve the quality and efficiency of emergency medical care.

Objective: All-trans retinoic acid(ATRA) is a classic drug that can induce tumor differentiation,and its influence on the aberrant methylation of cancer cells has been studied insufficiently.The objective of this study was to observe the influence of ATRA on the methylation of the RARa gene promoter in ovarian cancer cell line COC2 and its relationship with the RARa expression.Methods: The ovarian cancer cell line COC2 was treated with different concentrations of ATRA for different times.Methylation specific PCR(MSP) and bisulfate sequencing methods were used to detect the changes in the methylation of the RARa promoter after ATRA treatment.RT-PCR was employed to observe the changes in the expression level of RARa mRNA.Results: Aberrant methylation of the RARa gene promoter was found in the ovarian cancer cell line COC2.ATRA treatment decreased the number of RARa promoter methylation sites in COC2 within a certain scope in a concentrationand time-dependent manner,and increased the expression of RARa mRNA.Conclusion: Aberrantly high methylation of the RARa promoter exists in the ovarian cancer cell line COC2;ATRA can partially reverse the methylation and increase the RARa mRNA expression.

Objective: Docetaxel as a newly semi-synthesized anti-tumor drug,exhibits significant cyrotoxic activity and enhanced sensitivity for radiotherapy.The aim of this study was to investigate the correlation of the apoptosis of human Hela cell line with the expressions of TRAIL and its receptors induced by the combination therapy of Docetaxel with radiation.Methods: We treated the Hela line by Docetaxel,radiation,and combination therapy of Docetaxel with radiation,respectively,detected the apoptosis of the Hela cells using Hoechst 33342 staining and the TUNEL method,and observed the changes in the mRNA expressions of TRAIL and its receptors TRAIL-R in the three groups by RT-PCR.Results: Compared with the Docetaxel and the radiation groups,the apoptosis of the Hela cells was increased significantly in the combination therapy group,and so were the mRNA expressions of TRAIL and its receptors TRIAL-R1 and TRAIL-R2.Conclusion: The combination therapy of Docetaxel with radiation increased the apoptosis of the Hela cell line,which might be mediated by the up-regulation of mRNA expressions of TRAIL and its receptors TRAIL-R1 and TRAIL-R2.

Objective: Executive dysfunction is a typical characteristic of vascular cognitive impairment(VCI),with subcortical ischemia as its pathological basis.The aim of this study was to investigate the characteristics of event-related potential of visual-spatial working memory based on ischemic white matter lesions,and offer more electrophysiological evidence for the evaluation of VCI.Methods: We included in this study 24 patients with ischemic white matter lesions(13 mild and 11 severe cases) and 12 elderly healthy controls,and induced event-related potentials(ERP) of visual-spatial working memory from the delayed matching-to-sample task in all the participants.Results: Three waves were identified: N330,P420 and late negative component. On the two-ball-load,the N330 amplitude in the middle frontal,right frontal and occipital lobe was significantly smaller in the mild and severe lesion groups(P

Most patients with ischemic cerebrovascular diseases,after treated in hospitals during the acute stage,can return home or back to the community.Therefore,secondary prevention of the disease in the community is very important.