Chimeric antigen receptor T-cell (CAR-T) technology is based on genetic modification technology to express T-cell expression tumor specific chimeric antigen receptor bind tumor antigen in an antigen-dependent anti-MCH way. Single chain antibody fragment (scFv) of tumor-associated antigen (TAA) combines with up-stream activating sequence of T-cell in vitro. The forming recombinant plasmid transfects the purified and large scale proliferating T-cell in vitro by transfection technique. This process starts and activates specific killing reaction of tumor. The clinical application of cell therapy shows high efficiency and good anti-tumor effect in treatment of malignant neoplasm, such as leukemia, lymphoma, melanoma, which made CAR-T become the mainstream method of cell therapy.

CBI (Content-based instruction) , integrating the content and language, can be used to guide teaching EAP (English for academic purposes). Main Teaching Models based on CBI (Content-based instruction) include immersion model, theme-based instruction and content for language practice. EGAP (English for general academic purposes) curriculum can be set up in medical universities in the second and third academic years, such as medical integrated course, medical listening & speaking course, medical writing course. ESAP (English for specific academic purposes) curriculum can be set up in the fourth and fifth academic years, such as clinical English,nursing English and stomato-logical English. Theme-based instruction can be applied in medical integrated course and listening&speaking course, including creating situation to lead in the theme, assigning tasks to experience the theme, setting topics to deepen the theme and giving assignment to explore the theme. Content for language practice model can be applied into medical writing course, such as teacher's demonstrating and explaining, students' absorbing and imitating and mutual evaluating. Immersion model can be used in ESAP (English for specific academic purposes), such as choosing typical cases to teach in English, teaching ward round in English, doctor-patient communication in English. Preliminary practice was carried out for one year, experimental class with theme-based instruction and content for language practice model, and control class with traditional teacher-centered teaching model. At the end of the practice, they were given the same test and questionnaire, it was found that CBI teaching models facil-itated to improve the students' English level and also enhanced their study motive and independent study ability.

X-box binding protein -1(XBP-1)is a newly found protein that plays significant roles in protein folding and endoplasmic reticulum construction .The expression of XBP-1 is widely displayed in various kinds of tumor and is shown to take part in tumorigenesis and tumor progression .This review briefly summarizes the biology of XBP-1 and focuses on recent findings concerning its role in immune evasion ,tumorigenesis ,devel-opment of cancer ,angiogenesis ,hypoxia ,invasion and metastasis .

Objective To realize fine management of medical equipment maintenance,effectively improve the efficiency and save the cost of equipment maintenance.Methods A medical equipment maintenance management module was developed with hospital resource planning system and SQL Server 2008 platform so as to implement informatized management for equipment acceptance check,maintenance,processing and etc.Results The module realized fine management,controlled cost and enhanced social and economic benefits of the hospital.Conclusion The module contributes to medical equipment maintenance management informatization,and is of great significance for the improvement of the hospital.

Objective To analyze the variations of glycerol-3-phosphate dehydrogenase 1 like gene (GPD1-L) and address the association with sudden m anhood death syndrom e (SMDS). Methods The genom ic DNA was extracted from blood sam ples of the SMDS group and the norm alcontrolgroup.The exons, exon-in-tron boundaries and 3′-U TRs of coding region of GPD1-L w ere PCRam plified and DNAsequenced di-rectly to confirm the types of variations. The genotype frequency and allele frequency w ere analyzed statistically. Results There w ere tw ovariants in the SMDS group, c.465C>Tand c.*18G>T, the latter existed certain degree difference of genotype distribution and allele frequency betw een the SMDS group and the control group, but there was no statistically significant (P>0.05). Conclusion The relation be-tw een gene m utation of GPD1-L and the occurrence of Chinese SMDS deserves a further research.

Objective To evaluate the effectiveness of autologous platelet-rich gel (APG)in the repair of diabetic foot ulcers.Methods This study was a single-center,prospective,randomized controlled trial.A total of 60 patients with diabetic foot ulcers (Wagner grade 2 - 3 )were randomly divided into autologous APG group (treatment group)and recombinant bovine basic fibroblast growth factor gel group (control group).After 8 weeks, we compared wound healing rate and wound healing time at five levels (overall ulcer,superficial ulcer,sinus ulcer, Wagner 2 and Wagner 3)in the two groups.Results In APG treatment group and control group,the healing rate of overall sample ulcer (93.33% vs .63.33%,P =0.005),sinus ulcer (84.62% vs .36.36%,P =0.033),Wagner 3 (81.82% vs .30%,P =0.030)differed significantly,but did not significantly differ in superficial ulcer (100%vs .78.95%,P =0.106)or Wagner 2 (100% vs .80%,P =0.106).Ulcer healing time was 31 d vs .41.5 d,23 d vs .32 d,32 d vs .56 d,25 d vs .32 d,38 d vs .56 d,with significant difference between the two groups (P <0.05). Conclusion Autologous platelet-rich gel can effectively increase the curative rate of diabetic foot and shorten healing time.

Objective To investigate the value of contrast enhanced ultrasonography ( CEUS) in the diagnosis of hepatic epithelioid hemangioendothelioma( HEHE) . Methods The images of CEUS had been retrospectively evaluated in 21 lesions of HEHE which were confirmed by pathology . The perfusion patterns and time of enhancement were observed ,including time to begin enhancement , time to peak enhancement ,the washout time and the appearance of internal structures . Results The mean time of begin enhancement ,time to peak ,time to isoechogenity and hypoechogenity were ( 17 .4 ± 5 .2) s ,( 22 .0 ± 7 .2) s , ( 23 .9 ± 4 .6 ) s and ( 42 .2 ± 13 .7 ) s ,respectively . During the arterial phase , 8 lesions showed diffuse enhancement ,7 lesions showed rim-like enhancement and 6 lesions showed branch enhancement . The inner margin in 6 lesions showed speculate enhancement . The central portion of the tumors was not enhanced in part lesions of 8 cases . As to time of peak enhancement ,compared to the normal hepatic parenchyma , hypoenhancement ,isoenhancement and hyperenhancement were observed in 10 lesions ,6 lesions and 5 lesions respectively . Synchronous enhancement was observed in 11 lesions on CEUS ,rapid enhancement was observed in 8 lesions and slow enhancement was observed in 2 lesions . Twenty-one lesions manifested hypoechoic mass in portal phase and delayed phase . The boundary of lesions was unclear on conventional ultrasound and became distinct after contrast injection in 21 lesions . Conclusions CEUS is useful for the diagnosis of HEHE .

Objective To evaluate the efficiency and clinical value of modular flexible ureteroscope combined with Holmium laser lithotripsy for treatment of renal calculi. MethodsA total of 46 patients with renal calculi were treated with modular flexible ureteroscope combined with Ho:YAG lithotripsy in our hospital from December 2009 to May 2011.There were 19 cases in middle and upper calyx,8 cases in lower calyx,15 case in renal pelvic,and 4 cases in multiple calyxes.The calculi diameter ranged from 6mm to 31 mm (average in 15 ± 7.9 mm).Flexible ureteroscope was used to find renal calculus under epidural anesthesia,and Holmium laser lithotripsy was used at a maximum energy of 12 to 20W (0.8 - 1.0 J/15 -20Hz).F5 or F6 double-J tubes and catheters were indwelled routinely postoperatively.-examine with KUB and removethe catheter 2 days after operation.Re-examine with B-ultrasonography or KUB 4 weeks after op-eration to evaluate the stone free rate.Residual stones ≥4 mm were regarded as clinical significance of residual stone fragments. Results 45 operations were successful except one case changed to percutaneous nephrolithotomy (PCNL) because of ureteral stricture.The operation time was 45 -150 min (average in 110.4 ±25.3 min).The patients were discharged from hospital in 2 -5 days(average in 3 days) after operation.The stone detection rate was 95.6％ (44/46),and the stone free rate was 86.9％ (40/46) after one operation. No severe complications such as ureteral perforation or hemorrhea occurred. Conclusions Modular flexible ureteroscope combined with Holmium laser lithotripsy is effective and safe for treatment ofrenal calculi,meanwhile it can decrease the high maintenance costs of integrated flexible ureteroscope.

OBJECTIVETo investigate the changes in the quantity of colonizing Streptococcus mutans(S. mutans) and Actinomyces on the root surface plaque before and after post-core crown restoration of the mandibular first molars in the elderly patients.

METHODSA total of 30 elderly patients, each with one post-core crown restoration of the mandibular first molar, were randomly chosen to participate in the studies. Patients with mandibular first molars with post-core crown restoration and those with healthy contralateral mandibular first molars were divided into the test and control groups, respectively. Root surface plaques of the two groups were collected before tooth preparation, 72 h after preparation, one week after preparation, and one month after restoration. S. mutans, Actinomyces naeslundii (A. naeslundii) and Actinomyces viscosus (A. viscosus), were identified using colony morphology, biochemical techniques, and polymerase chain reaction (PCR). Plaque count was measured using microbial colony count.

RESULTSThe number of S. mutans and A. viscosus and A. naeslundii in the test group, which was statistically significant (P<0.05), increased 72 h after preparation. The quantities of S. mutans, A. viscosus, and A. naeslundii one week after preparation were significantly different (P<0.05). The plaque count of S. mutans, A. viscosus, and A. naeslundii in the test group decreased one month after restoration (P<0.05).

CONCLUSIONThe quantities of S. mutans, A. viscosus and A. naeslundii increase one week after preparation but decrease one month after restoration. The finding suggests that dentists should educate patients about plaque control during the early period after tooth preparation.

Actinomyces ; Actinomyces viscosus ; Aged ; Bacteria ; Crowns ; Dental Plaque ; Humans ; Post and Core Technique ; Streptococcus mutans ; Tooth Root

Objective To evaluate the efficiency and clinical value of modular flexible ureteroscope combined with Holmium laser litho-tripsy on the treatment for upper ureteral calculi of solitary kiden. Methods There were 26 cases of upper ureteral calculi of solitary kidney, including 12 cases of left ureter calculi and 14 cases of right ureter calculi. The diameter of the calculi ranged from 0. 6~2. 2 cm, averagely (1. 38 ± 0. 22) cm. F6 double-J tubes were indwelled postoperatively for 4 weeks, and catheters were indwelled postoperatively for one week. Examine with KUB one day after operation to evaluate the effective rate. Results The Ureteral guiding sheath were successfully implanted in 23 cases, 2 cases underwent second lithotripsy after indwelling D-J tubes 2 weeks later, D-J tubes failed to be implanted only in one case, which has changed to percutaneous nephrolithotomy (PCNL) for ureter stricture. The stone free rates was 88. 5%(23/26)after the first ses-sion,and it was 100%(26/26)at the end of the session. The operation time was 15~45 min, meanly (27 ± 3. 2) min. One patient had ureter perforation during the operation, and one patient had severe infection after operation. Conclusion The modular flexible ureteroscopy com-bined with Holmium laser lithotripsy is an effective and safe treatment, especially for upper ureteral calculi of solitary kideny, and it should be considered as the first choice for solitary kidney calculi.