Objective　To investigate the early changes and clinical significance of plasma endothelin(ET) and nitric oxide(NO) in patients with acute brain injury.　Methods　The plasma ET and NO concentration at 1 day after injury were checked with radioimmunoassay and Green method in 48 cases of acute brain injury, in 42 cases of non-brain injury and in 38 healthy volunteers. 　Results　 The early plasma concentrations of ET and NO were (109.73±12.61) ng/Lf and (92.82±18.21) μmol/L, respectively, in 48 cases of acute cerebral injury, which were higher than those in the non-brain injury group［(67.90±11.33) ng/L and (52.66±12.82) μmol/L, respectively, P<0.01］ and in the normal control group ［(50.65±17.12)ng/L and (36.12±12.16) μmol/L, respectively, P<0.001］. The amounts of ET and NO in the patients with severe brain injury were (116.18±18.12) ng/L and (108.19±13.28) μmol/L, respectively, which were significantly higher than that of the moderate brain injury group［(92.33±16.32) ng/L and (76.38±12.71) μmol/L, respectively, P<0.01］.The early levels of ET and NO were negatively related to the GCS scores of the patients with acute brain injury. The amounts of ET and NO were (126.23±15.23)ng/l and (118.18±10.12) μmol/L, respectively, in the patients with subdural hematomas, which were significantly higher than those in the patients with epidural hematomas ［(81.13±12.37) ng/L and(68.02±13.18) μmol/L, respectively, P<0.01］. The stable plasma concentrations of ET and NO at 14 days after injury in the patients with acute brain injury and with non-brain injury were similar to that in the normal controls. 　Conclusions　 ET and NO are related to the pathophysiological process in the early period of acute brain injury, and the values of ET and NO correlate positively with the clinical manifestations. The changes of plasma ET and NO can be regarded as important indexes to diagnose the severity of acute brain injury.

The marrow stromal osteoblasts from New Zealand rabbits were seeded on coral treated with L-polylysine, fibronectin and culture medium only, then the cells/coral composites were cultured in vitro. The cells/coral composites were observed for the process of cells growth and matrix formation at 7, 14 and 21 days after culture. With the aid of electron microscope,it was demonstrated that on the surface of the coral holes,which was treated with fibronectin, there were more adhering osteoblasts and matrix formation than those treated with both L-polylysine and culture medium after 7 and 14 days.Cell count in coral blocks was determined by doing a fluorimetric DNA assay. Although the samples treated with L-polylysine demonstrated higher cell count than the coral treated with culture medium after 7 days, there was no statistically difference between the two after 14, 21 days. At each time point, the samples treated with fibronectin showed higher cell count and alkaline phosphatase activity than the orals otherwise treated, and the cell count also increased with culture time. The study suggests that fibronectin has a significant effect on promoting the adhesion and proliferation of osteoblasts on the surface of coral.

Humans are negatively affected by parasitic infection.However, recent researches revealed that to some extent, parasitic infections are advantageous to humans.Parasitic infections are found to benefit patients of inflammatory bowel disease, diabetes mellitus, autoimmune disease and allergic disorder.Furthermore, they promoted studies on pathogenesis of these diseases, and therefore on safe and effective therapeutic strategy.In addition, by taking the Caenorhabditis elegans as model organism, researchers have made a breakthrough in the area of life science, including signal transduction, functional genomics and drug screening.

Objective: To explore effects of large dose gamma globulin on cardiac function and immune regulation in patients with dilated cardiomyopathy (DCM) and heart failure (HF).Methods: According to random number table, a total of 90 DCM + HF patients were divided into routine treatment group (n=45) and gamma globulin group (n=45, received gamma globulin based on routine treatment, 400 mg kg-1 d-1 intravenous drip for 5d).After three months, therapeutic effect, cardiac function, levels of cardiac troponin T (cTnT), cTnI, N terminal pro brain natriuretic peptide (NT-proBNP) and anti-cardiac myosin heavy chain auto-antibodies (AMHCA) IgG titer before and after treatment, incidence of adverse reactions were observed and compared between two groups.Results: After three-month treatment, total effective rate of gamma globulin group was significantly higher than that of routine treatment group (80.00% vs.57.50%, P=0.02);compared with routine treatment group after treatment, there were significant reductions in levels of cTnT [(0.54±0.18) μg/L vs.(0.31±0.12) μg/L], cTnI [(1.35±0.18) μg/L vs.(0.72±0.13) μg/L], NT-proBNP [(758.34±64.28) pg/ml vs.(708.34±60.22) pg/ml], and significant rise in left ventricular ejection fraction [LVEF, (39.35±6.23)% vs.(47.32±6.10)%] in gamma globulin group, P<0.05 all;compared with before treatment and routine treatment group after treatment, there was significant reduction in AMHCA IgG titer [(0.099±0.047), (0.092±0.045) vs.(0.069±0.032), P<0.05 both] in gamma globulin group;incidence rate of adverse reaction in gamma globulin group was significantly higher than that of routine treatment group (22.22% vs.6.67%, P=0.04), but the symptoms were mild, and they recovered after symptomatic treatment.Conclusion: Large dose gamma globulin can significantly improve cardiac function and possesses good immune regulation effect in patients with dilated cardiomyopathy and heart failure.

Based on high requirement on trainingtarget ofcultivating8-year medical students and combined with the characteristic of general surgical teaching,we applied logical thinking to strengthen students'clinical thoughts and self-analysis ability to make them become the advanced medical talents with good clinical thoughts.

Objective:To observe the effect on ovarian cancer immunotherapy by dendritic cells (DC) which activated by Epithelial cell adhesion molecule (EpCAM) induce antigen-specific CD8+ cytotoxic T lymphocytes (CTL) and to provide some help to ovarian cancer immunotherapy.Methods: Interleukin (IL)-12,and IL-10 of DC were tested after inducing by EpCAM.Subsequently,EpCAM specific CTL CD8+ was induced by EpCAM-DC.The therapeutic effect and interferon (IFN)-γ of EpCAM-DC-CD8+ CTL on normal ovarian epithelial cells IOSE80 and ovarian cancer cell SKVO3 was detected.After treatment of EpCAM-DC-CD8+ CTL,the volume of ovarian tumor of bearing BALB/c-nu/nu mice was detected.Meanwhile,the morphology changes of tumor tissue were observed by HE staining.Results: Compared with PBS,EpCAM stimulation significantly inceased surface markers DC80,DC83,DC86 and HLA-DR levels,and added up to 4.79,4.85,4.60 and 10.91 times (P<0.05).EpCAM stimulation significantly increased the expression of IL-12 and reduced the secretion of IL-10 (P<0.05).Both of DC-CD8+ CTL and EpCAM-DC-CD8+ CTL resulted in minute amount of IOSE80 cell killing (P>0.05).However,the killing rate of EpCAM-DC-CD8+ CTL on SKVO3 cells was 6.82-folds as much as that of DC-CD8+ CTL.Animal experiments showed that ovarian cancer transplantation tumor volume ratio after EpCAM-DC-CD8+ CTL treatment,was significantly lower than PBS group and DC-CD8+ CTL group,which reached 0.27 and 0.28 times,respectively (P<0.05).HE staining showed that EpCAM-DC-CD8+ CTL treatment resulted in significant changes of tumor tissues in pathology.Conclusion: EpCAM protein stimulated the maturation of DC that induced the production of EpCAM specific CD8+ CTL.EpCAM-DC-CD8+ CTL can effectively kill ovarian tumor cells and delay the growth of tumor,which is of great significance for the immunotherapy of ovarian cancer.

The CD19-targeted chimeric antigen receptor (CAR) T-cell treatment has achieved clinical success in treating B-cell lineage hematopoietic malignancies. This accomplishment involved the precise and efficient elimination of tumor cells by tumor-associated an-tigen-redirected immune cells. As a result, the reinitiation of several CAR T-cell (CART) based clinical trials in solid tumors was promot-ed. However, developing a feasible and efficient CAR T based therapeutic modality for solid tumors is urgently needed given the differ-ential properties between liquid and solid tumors. In this review, we discuss the advances in the management of cytotherapeutic mo-dality for solid tumors. The aspects considered include toxicity management, target selection, and primer or conditioning treatment.

The miR-17-92 cluster,consisting of six individual microRNAs,including miR-17,miR-20a,miR-18a,miR-19a,miR-19b and miR-92a-1,is a kind of typical oncogenic polycistron microRNA.MiR-19 (containing miR-19a and miR-19b),as the key oncogenic component in miR-17-92 cluster,is overexpressed in human cancers including lymphomas,leukaemia,lung cancer,breast cancer and multiple myeloma,and has been one of research focus in recent years.It is found that miR-19 promotes tumor growth,invasion and metastasis through negative regulation of target genes such as PTEN,PP2A,Bim,SOCS1,and is correlated strongly with PI3K-AKT-mTOR pathway.MiR-19 plays an important role in tumor genesis and development.

Objective To evaluate the causes of postoperative complications in severe liver rupture and explore the prevention experienees.Methods The clinical data of 66 liver rupture patients who underwent surgical treatment in our hospital from January 2005 to July 2012 were retrospectively analyzed.The commou complications after surgery and the treatment measures of the complications were sludied.Results There were 9 deaths of severe liver rupture after surgery and related complications were found in 22 cases,including bile leakage (5 cases),intrahepatic abscess (3 eases),subphrenic infection (3 cases),pleural effusion (8 cases),intra-abdominal hemorrhage (2 cases),stress ulcer bleeding (2 cases).Conclusions Using damage control theory could improve the cure rate.Precise liver transection and postoperative excellent management was able to reduce the incidence of postoperative complications in severe liver rupture.

Continuing medical education is one of major parts in medical education system of minimal invasive surgeon. Based on the characteristics of net continuing medical education such as freedom of learning, no regional restriction and abundant resource, combined with visualized teaching of minimal invasive surgery education, the novel training model of e-learning based on internet was applied to establish minimal invasive surgery continuing education system.