Liver cancer is one of the most common malignant tumors in China.The efficacy of traditional treatment for liver cancer is unsatisfactory,and the prognosis of the patients is poor.In recent 10 years,with the development of the molecular biological techniques,genetic therapy has become a new and promising approach for liver cancer.Of which,adenovirus mediated herpes simplex virus thymidine kinase (ADV-tk) for the treatment of liver cancer is widely applied.The enzyme secreted by ADV-tk transformed the prodrug gancyclovir (GCV) to the cytotoxic agents and thus to kill the liver cancer cells.The results of multiple animal and clinical experiments showed that ADV-tk/GCV is effective for the treatment of liver cancer.In this article,the recent progress of ADV-tk/GCV in the treatment of liver cancer was reviewed.

Objective:To investigate the mechanism of lung injury after cardiopulmonary resuscitation(CPR) in rats. Methods: Cardiac arrest was induced by asphyxiation(succinylcholine) and ice-cold 0.5 mol/L KCl in rats and CPR was carried out 5 min after arrest. Sixteen adult male Sprague-Dawley rats were randomly allocated into 2 groups:control group(n=8) and CPR group(n=8). The blood gas analysis,serum level of tumor necrosis factor ?(TNF-?),lung tissue wet mass/dry mass ratio(W/D),lung malondialde-hyde(MDA) content and myeloperoxidase(MPO) activities were measured 3 h after CPR. The histological appearances of the lungs were observed under light and electron microscope. Results: Compared to the control group,the lung W/D,serum TNF-?,pulmonary MDA and MPO activity increased dramatically in CPR group while PaO 2 decreased 3 h after resuscitation(P

0.05). The core temperature, levels of TNF-?,IL-6 and IL-8 were lower at t2 and t3 in group Ⅱ than those in group Ⅰ (P

Objective To explore the role of monitoring the cellular immune function in preventing and treating the fungal infection in the recipients of liver transplantation. Methods 679 cadaveric liver transplantations (from Jan. 2004 to Jan. 2010) were retrospectively studied. All the cases were divided into 3 groups according to different treatments and preventing regimens. The patients in groups A, B, C were treated based on the clinical experiences (394 cases), T lymphocyte subsets counting (151 cases), and combination of ATP values of CD4+ T cell and T lymphocyte subsets counting (134 cases), respectively. The infection, mortality and acute rejection rate were analyzed. The relationship between fungal infection and cellular immune function was investigated.Results The fungal infection rate in groups A, B, and C was 28. 9 %, 21.2 %, and 19. 4 % (P<0. 05), the morbidity rate was 16. 7 %, 12. 5%, and 3. 8% (P>0. 05), and the acute rejection rate was 28. 4 %, 17. 2 %, and 13. 4 % (P<0. 01), respectively. The CD4+ T lymphocyte counting in all cases of fungal infection was (147±43)×106/L. The morbidity could reach 50. 0 % when the CD4+ T lymphocyte counting < 100 ×106/L, while it was 2. 4 % when the counting was between (100-200) ×106/L (P<0. 01). The CD4+ T lymphocyte counting had no linear relation with the ATP value.The ATP value in fungal infection cases was (117 ± 61)μg/L. Conclusion The cellular immune function test could be quantitatively evaluated according to the T lymphocyte subsets and ATP value of CD4+ T lymphocyte. And individualized immunosuppressive therapy could be adjusted accordingly.Therefore, cellular immune function could be instructive in preventing and treating the fungal infection after liver transplantation.

Objective To analyze related perioperative risk factors of acute respiratory distress syndrome (ARDS) early after orthotopic liver transplantation (OLT).Methods The cases from the recipients having undergoing OLT,aged from 15 to 65 years and having no chronic respiratory diseases and hyoxemia were collected.The exclusive criteria were as follows:(1) the patients dead or automatic discharging at the day after the OLT or during the OLT; (2) the patients suffered from severe surgical technic complications; (3) initial poor graft function occurred; (4) marginal donor; (5) pulmonary wedge pressure (PAWP)＞ 2.394kPa.251 patients were enrolled in this analysis,who were grouped according to whether they developed ARDS (group B) or not (group A) in the first postoperative day.The analyzed factors were as follows:(1) the sex,age and weight of the recipients; (2) preoperative variables of recipients:Child-Pugh and Model for end-stage liver disease (MELD) score,left vent ricular ejection fractions,oxygenation index,the serum levels of creatinine,BUN,TB,albumin,prealbumin,fibrinogen and hemoglobin,white blood cells (WBC),platelet count and international normalized ratio (INR) ; (3) the variables of donator:age,the time of warm and cold ischemia; (4) the intraoperative variables:operative time,anhepatic phase,the volumes of hemorrhage and blood-transfusion (red cell suspension and plasma),transfusion volume; (5) postoperative variables of recipients:the serum levels of creatinine,blood urea nitrogen (BUN),total bilirubin (TB),albumin,alanine aminotransferase (ALT),sodium and potassium,fibrinogen and hemoglobin,WBC,platelet count and INR.Results The mild ARDS incidence early after OLT was 25.5 ％ (65/251) and the moderate or severe was 4.8％ (12/265).Single factor analysis showed that the factors having significant difference between group A and group B were as follows:the age of the recipients,preoperative variables (Child-Pugh and MELD score,the preoperative serum levels of BUN,TB,prealbumin,fibrinogen and hemoglobin,WBC,platelet count and INR),the intraoperative variables (the volumes of hemorrhage and blood-transfusion including red cell suspension and plasma) and the postoperative variables (the serum levels of BUN,TB,sodium,fibrinogen and hemoglobin,WBC,platelet count and INR).The significant factors were put to the analysis of LOGISTIC regression,and the results showed that the age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume,postoperative serum level of sodium were the independent risks contributing to ARDS.Conclusion The mild ARDS incidence early after OLT was high but the the moderate or severe incidence was low.The age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume and postoperative serum level of sodium may be the main risk factors to lung injury after OLT.

Objective To explore the relationship between peripheral differential blood count and ATP value in Cell CD4 + T tested by ImmuKnow method in liver transplants. Methods In this study 49recipients after classic orthotopic liver transplantation (OLT) were enrolled. In a period from two weeks to two months after transplantation when all were free of glucocorticoid. Blood were sent for WBC differential samples count and ATP value in Cell-CD4 + T tested by ImmuKnow method via SPSS17. 0 software. Five more samples were selected randomly for duplicated testing of the indices in Week2, 3, 4,6 and 8 after the transplanting operation to further verify the relativity. Results White blood cell count has the highest relativity with ImmuKnow ATP value at 0. 821. The 5 recipients were repeatedly tested for ImmuKnow ATP values that were found positively correlated to cell count with a coefficient of over 0. 5. Conclusions The peripheral leukocyte count in early stage after liver transplantation is in positive correlation with ATP value in Cell CD4 + T, and the changes of numeration of leukocyte reflect changes of ATP value.

Objective To explore the therapeutic effects of electroacupuncture on regional cerebral blood flow (rCBF) in patients with post-stroke depression. Methods 21 patients with post-stroke depression were randomly divided into electroacupuncture group (n=11) and drug group (n=10). The electroacupuncture group received electroacupuncture on double Hegu (LI4) and Taichong (LR3) once a day for 8 weeks, while the drug group took fluoxetine hydrochloride dispersible tablets 20 mg a day for 8 weeks. They were evaluated with Hamilton Self-rating Scale for Depression (HAMD) before, and 2 weeks, 4 weeks and 8 weeks after treatment respectively. The rCBF were measured with single positron emission computerized tomography (SPECT) before and 8 weeks after treatment. Results The score of HAMD decreased more in the electroacupuncture group than in the drug group 2 weeks after treatment (P<0.05), and there was no significant difference between the two groups 4 and 8 weeks after treatment (P>0.05). The rCBF was significantly greater in the electroacupuncture group than in the drug group. Conclusion That electroacupuncture is effective on post-stroke depression, which may be related with the increase of the rCBF levels.

Objective To evaluate the myocardial protective effect of dexmedetomidine in the pediatric patients undergoing total correction of tetralogy of Fallot.Methods Forty ASA physical status Ⅱ] or Ⅲ pediatric patients of both sexes,aged 9 months-5 yr,weighing 7-21 kg,scheduled for elective total correction of tetralogy of Fallot under cardiopulmonary bypass,were randomly divided into 2 groups (n =20 each):control group (C group) and dexmedetomidine group (D group).Anesthesia was induced with iv injection of midazolam,sufentanil,etomidate and rocuronium.The patients were endotracheally intubated and mechanically ventilated.After intubation,dexmedetomidine was infused intravenously at 0.6 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume normal saline was given instead of dexmedetomidine in group C.Venous blood samples were obtained before operation,at the end of operation and at 24 h after operation for determination of plasma TNF-α and IL-6 concentrations.The occurence of anoxic spells was recorded.Results The concentrations of plasma TNF-α and IL-6 were significantly lower at the end of operation and 24 h after operation in group D than in group C(P ＜0.05).The incidence of anoxic spells was 0 in group D,however it was 20％ in group C.Conclusion For the pediatric patients undergoing total correction of tetralogy of Fallot under cardiopulmonary bypass,dexmedetomidine infused at 0.6 μg· kg-1 · h-1 during operation can exert myocardial protective effect with clinical significance.

The evaluation of undergraduate course teaching by the Ministry of Education is a challenge to all our teachers,but it is also a chance for us to improve the teaching quality of infectious disease class.In this article we summarized the experience of the infectious disease education reform of many years,and discussed the approach and means of improving the teaching quality of infectious disease class.

Objective Neuroinflammation following traumatic brain injury (TBI) may give rise to neurodisorder.This study aimed to investigate the effect of intranasal delivery of nerve growth factor ( NGF) on neuroinflammation following TBI and its action mechanism in rats. Methods Thirty-six male adult Sprague-Dawley rats were equally divided into a sham , a TBI, and a TBI+NGF group.The rats in the TBI +NGF group were treated with NGF intranasally at 12 and 24 hours after TBI.The levels of IL-1βand TNF-αin the injured cerebral cortex were detected by ELISA , the DNA-binding activity of NF-κB evaluated by EMSA , and the expres-sion of amyloid-β( Aβ42 ) determined by Western blot . Results NGF attenuated the inflammation following TBI .Compared with the TBI group, the level of IL-1βwas obviously decreased in the TBI +NGF group at 12 hours (70.65 ±3.10 vs 37.51 ±1.92) and 24 hours (68.85 ±8.10 vs 36.23 ±2.99, P<0.05), and so was that of TNF-α(47.12 ±7.38 vs 27.63 ±5.77 and 56.15 ±11.20 vs 29.94 ±8.62, P<0.05).The DNA-binding activity of NF-κB was reduced to 111.62 ±0.49 and 131.52 ±0.88, and the expression of Aβ42 to 0.23 ±0.008 and 0.52 ±0.004 at 12 and 24 hours respectively after treatment with NGF , both with statistically significant differences from the TBI group (P<0.05). Conclusion Intranasal administration of NGF attenuates TBI-induced neuroinflamma-tion in rats, which may be associated with its regulatory effect on the Aβ42/NF-κB signaling pathway .