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.

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 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

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.

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.

Objective To investigate indications,technique,prognosis and complications of anterior flap hemipelvectomy (hemipelvectomy using a quadriceps femoris muscle flap with superficial femoral artery)in the treatment of pelvic tumors.Methods From April 2009 to October 2010,10 patients with pelvic tumors underwent anterior flap hemipelvectomy in our department.There were 9 males and 1 female,aged from 30 to 62 years (average,46 years).There were 7 cases of chondrosarcoma,1 case of epithelioid sarcoma,1 case of pleomorphic liposarcoma and 1 case of spindle cell sarcoma.Results Nine patients were followed up for 12 to 30 months (average,21.5 months).Superficial skin necrosis occurred in 1 patient,while there was no wound infection.Local recurrence (33.3％) occurred in 3 patients,including 2 cases of chondrosarcoma and 1 case of epithelioid sarcoma.Three patients died at last,including 2 patients with local recurrence and 1 with pulmonary metastasis from liposarcoma.Two patients survived with pulmonary metastasis,and remaining 3 patients survived without recurrence and metastasis.Conclusion Anterior flap hemipelvectomy is indicated for:(1) patients with extensive soft tissue sarcoma in the buttock,and the tumor or reaction zone involve the subcutaneous tissue; (2) patients with recurrent pelvic tumors,and the conventional posterior flap can't be used due to contamination by the original incision; (3) patients whose posterior flap has poor blood supply due to radiotherapy or other factors.The prerequisite of the surgery is that the blood stream between external iliac artery and femoral artery is unobstructed; moreover the blood vessels are not in the tumor reaction zone.Compared with conventional posterior flap,the anterior flap hemipelvectomy is an easier procedure,which not only can easily cover surgical defect and obtain better surgical margin,but also has less complications.

Objective To investigate the risk factors associated with feeding intolerance in very low birth weight infants (VLBWI) and to investigate the beneficial factors for preventing feeding intolerance.Methods Retrospectively analysis was carried out in 151 VLBWI cases in our hospital from January 2005 to November 2010.Logistic regression analysis was performed to find the risk factors of feeding intolerance.Results The overall rate of feeding intolerance in VLBWI was 47.7 ％ (72/151).Dysporia and infection were associated with feeding intolerance in VLBWI (Wald x2 =7.748 and 4.555,P =0.05 and 0.033 respectively).Gender,multifetation were not associated with feeding intolerance(Ps ＞0.05).Conclusion The feeding intolerance is associated with dysporia and infection in VLBWI.

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.