Objective To investigate the accuracy of liver volume measurement in patients with primary hepatocellular carcinoma by using the 3D + medical imaging visualization processing system. Methods Thirty patients who were clinically diagnosed as primary hepatocellular carcinoma and underwent surgical resection before preoperative assessment were selected from January 2016 to November 2016. Preoperative thin-slice CT images were transferred into the 3D + medical imaging visualization processing system for hepatic volume measurement, the predictive resection volume were measured and statistically analyzed with that of intraoperative specimen according to water measurement method. Results All patients had complete resection of tumor, the average volume of predictive resection calculated by the 3D software was (408.84 ± 177.07) ml, the average volume of intraoperative specimen measured by the water test was (399.95 ± 176.15) ml, the difference was not statistically significant (t=1.502, P=0.144), and the average percentage error was (6.21 ± 4.73) %. Pearson correlation analysis showed that there was significant correlation between them (r=0.983, P<0.05). Conclusion 3D+medical image visualization processing system is a simple, intuitive and accurate method for liver volume measurement, which can provide the basis for the accurate measurement of liver volume and the implementation of complex hepatectomy, and guide the precise hepatectomy.

Objective: To investigate the role of anti-inflammatory cytokine IL-10 in the pathogenesis of asthma.Methods:IL-10 internal standards was constructed by restriction digest.The expression levels of IL-10 mRNA were determined in peripheral blood and induced sputum of 23 asthmatic patients by(RT-PCR) with this competitive internal standards. Results:There was no IL-10 mRNA expression in most of the asthmatics.IL-10 mRNA was detected in some catabatic patients.But IL-10 mRNA was readily detected in 29 normal subjects. Conclusion:Airway inflammation of asthma was related to the expression of IL-10 gene.Asthmatic patients may have difficulty in IL-10 synthesis with transcript.

With the rapid development of nanotechnology, nano oncology medicine that is formed through the combination of nano science and oncology medicine has become an important field emerging in nano science. Because of its unique optical properties, the gold nanorod (GNR), that is a rod-shaped nano materials, has shown great potential applications in the biomedical field, especially, in GRNs thermotherapy, radio-sensitizing effect therapy and targeting therapy of the tumor. Being a newly-developed therapy, gold nanorods combined with internal radiotherapy has already obtained excellent durative effect in targeting therapy of tumor. This paper aims to make a comprehensive review about its mechanism and its clinical application and research situation in recent years.

Objective To investigate the impact of hs-CRP and IVUS on major adverse cardiac event in patients who after coronary artery intermediate lesions stent implantation.Methods 82 patients with clinical diagnosis of coronary heart disease who had a segmental stenosis degree is 40％ ～ 70％ in one major coronary artery on coronary angiography,all of the patients do intravascular ultrasound,patients had minimal lumen area(MLA) of intermediate lesions ≤ 4mm2( the left main coronary artery)or≤ 6mm2( left main coronary artery) who received percutaneous coronary intervention(PCI),and the patients were divided into 2 groups,hs-CRP rise group(≥3mg/L) and hs-CRP normal group(＜3mg/L),compared the rate between the two groups in hospital and follow up periods by typical angina,nonfatal myocardial infarction,cardiac death and target-vessel revascularization and other major adverse cardiac events (MACE).Results The rate on major adverse cardiac event in hs-CRP rise group was significantly higher than the normal group(P ＜0.01 );the restenosis rate in hs-CRP rise group higher than hs-CRP normal group(P ＜0.01 ).Conclusion hs-CRP could predict the rate on major adverse cardiac event in patients with after coronary artery intermediate lesions stent implantation,the patients of hs-CRP rise group should strengthen antiplatelet,anti-inflammatory treatment etc.

Objective To establish a sensitive,specific,simple and high-throughput method for detection of the epidermal growth factor receptor (EGFR) mutation in the plasma samples of patients with non-small cell lung cancer (NSCLS) by the use of mutant-enriched liquid chip (MEL) assay.Methods The specific probes for the EGFR exon19 E746-750 deletion,exon 21 L858R mutation and wild-type sequence were designed and coupled to the microspheres coding with different fluorescent dye.The probe coupling efficiency was verified by crossing hybridization test with biotin-labeled reverse sequence.A blood-based MEL approach which integrates a sensitive mutant-enriched PCR and quantitative high throughput liquid chip assay for assessment of EGFR mutations was developed.The sensitivity and specificity of MEL was further evaluated using the mixture with different copy numbers of mutant and wild-type plasmids as template.The mutations of exon 19 and 21 of EGFR gene in plasma samples from 201 patients with stage ⅢB or Ⅳ NSCLC who enrolled in the First Affiliated Hospital of Guangzhou Medical College from September 2008 to April 2010 were analyzed by both the MEL and the mutant-enriched PCR assay.The result comparison was made between direct sequencing and MEL in 50 cases whose EGFR gene type had been tested by MEL and mutantenriched PCR.The correlation of EGFR gene mutation and the response to the Geftinib treatment was analyzed in 16 patients with lung adenocarcinoma as well.Results The probes were successfully coupled to the microspheres encoding with different fluorescent dye,and could be specifically recognized by the corresponding target sequence.The MEL was capable of detecting as few as 10 copies of EGFR mutants (sensitivity was 0.1％).Among the enrolled 201 cases of advanced NSCLC,the detection rate of the EGFR exon19 E746-750 del and exon 21 L858R was 55.7％ (112/201) by MEL assay.Conpared with mutantenriched PCR[58.2％ (117/201)],the coincidence rate was 97.5％ (196/201).There was no statistically significant difference between the results of mutant-enriched PCR and MEL (x2 =3.20,P ＞ 0.05).The mutations detection rate was 22.0％ (11/50) by directing sequencing,which was significantly lower than by MEL[50.0％ (25/50),x2 =12.07,P ＜ 0.05].Among the 16 patients treated with Gefitinib,9 cases who had EGFR mutation showed a higher response rate(P =0.041)and prolonged progression-free survival (x2 =6.76,P =0.009) after the treatment compared to those 7 who without EGFR mutation.Conclusions A new method of MEL with accuracy,specificity,fast and high-throughput is established for the detection of EGFR 19 E746-750 deletion and exon 21 L858R mutations in plasma from advanced NSCLC patients.It has the ability to provide the most direct and valuable guidance for clinicians to make decision on EGFR tyrosine kinase inhibitors therapy in the advanced NSCLC paticnts.

BACKGROUND:The selective immunosuppression on transplanted organ was realized by local drug delivery system,which is one of efficient ways to avoid many kinds of side reactions induced by systemic drug delivery.By using the characteristics that adrenal gland can secret glucocorticoid,the adrenal gland or adrenal implant as the way of local drug delivery of glucocorticoid for transplanted organ is hopeful to avoid the complications induced by systemic and amount of use of glucocoticoid.OBJECTIVE:To establish a model of adrenal gland self-implantation in greater omentum,and to observe the protection of the adrenal gland implant on transplanted liver.DESIGN,TIME AND SETTING:This randomized controlled animal experiment was performed in the Experimental Animal Center of Guizhou Provincial People's Hospital from May 2007 to October 2008.MATERIALS:Fifty male Sprague Dawley rats were assigned as donors,and fifty male inbred strain Wistar rats were assigned as recipients.METHODS:After feeding one week,the recipient rats were randomly divided into two groups with 25 rats in each group.In liver transplantation after adrenal gland self-implantation in greater omentum group,allogenic liver transplantation was performed after successful model establishment of adrenal gland self-implantation in greater omentum.In simple liver transplantation group,only allogenic liver transplantation was performed.No immunosuppressant was used after transplantation in both of the two groups.MAIN OUTCOME MEASURES:The survival time of rats was observed.The morphology of the transplanted livers and the adrenal implants was observed at different time points.The activities of serum aspartate aminotransferase(AST),as well as the concentration of serum corticosteroid and total bilirubin were detected at different time points.RESULTS:The recipient adrenal implants recovered their endocrinal function at 7 weeks after adrenal gland self-implantation in greater omentum.After liver transplantation,histological examination showed that the adrenal implants survived well.The median survival time of rats in the liver transplantation after adrenal gland self-implantation in greater omentum group was more than 30 days,which is obviously longer than that(12 days) in the simple liver transplantation group.There was no significant difference in concentration of serum corticosteroid between the two groups.At 7 days after transplantation,activities of serum AST and concentration of total bilirubin of rats in the simple liver transplantation group were significantly higher than those in the liver transplantation after adrenal gland self-implantation in greater omentum group(P ≤ 0.05).In the liver transplantation after adrenal gland self-implantation in greater omentum group,pathological changes of transplanted livers showed as grade 0 according to Williams standard.In the simple liver transplantation group,a mild rejection appeared at 3 days after transplantation,and the pathological changes turned to severe and reached grade 3 according to Williams standard at 7 days.CONCLUSION:Adrenal implant which survives and recovers its endocrinal function after self-implantation in greater omentum has protection on the transplanted liver in early stage.

Objective To evaluate the association between bradycardia and neurological sequel in patients with restoration of spontaneous circulation (ROSC) after cardiopulmonary resuscitation (CPR) during targeted body temperature management (TTM).Methods Forty-three unconscious patients with ROSC after CPR were treated with TTP.The patients were cooled with therapeutic hypothermia to body temperature target range (32-34°C) after cardiac arrest and divided into bradycardia and control groups depending on the lowest heart rate less than 50 beats/min and more than or equal to 50 beats/min respcetively at that time.The bispectral index (BIS) and the neuron-specific enolase (NSE) values were respectively recorded at the following intervals,0h (h0)、24h (h24)、48h (h48)、72h (h72) after ICU admission.Neurological outcome was defined according to the Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge.Results Compared with the control group,during TTM the bispectral index levels were significantly higher in the bradycardia group at h0,h48,h72 after admission,(h0 bradycardia group 73.0 ± 12.3;control group 58.0 ± 18.6,P ＜0.01)、(h48 bradycardia group 71.4 ± 21.2;control group 46.3 ± 18.9,P ＜ 0.01)、(h72 bradycardia group 78.6 ± 24.6;control group 51.8 ± 24.1,P =0.01).The neuron-specific enolase level in bradycardia group was significantly lower than that in control group on day3 (118.8 ± 118.8 ng/mL vs.248.3 ± 191.9 ng/mL,P =0.02).The level of CPC in the bradycardia group was significantly higher than that in the control group (P =0.046).Conclusions Patients with bradycardia during TTM had favorable neurological outcome,which could provide evidence for clinical treatment and prognostic evaluation of the patients.

Objective To evaluate the prognostic value of the neuron-specific enolase ( NSE ) and bispectral index ( BIS) in patient with mild therapeutic hypothermia ( MTH) after cardiopulmonary resuscitation ( CPR ) .Methods Forty-six patients with restoration of spontaneous circulation ( ROSC ) after CPR were treated with MTH.The BIS values were recorded and the serum NSE was measured at the following times:24 h, 48 h, and 72 hours after ICU admission.Neurological outcome was classified according to the Pittsburgh cerebral performance category ( CPC 1 to 5) at 3 months after ICU discharge.Results Fourteen patients had a good neurological outcome with CPC score 1-3, and thirty-two patients had a poor neurological outcome with CPC 4-5 at 3 month.Compared with good outcome group, the NSE values were significantly higher in the poor outcome group on day 2 and day 3 after admission [48 h: (90.1 ±42.7) ng/mL vs.(33.2 ±17.5) ng/mL;72 h: (95.4 ±37.0) ng/mL vs. (29.2 ±17.0) ng/mL, P<0.05].NSE increased markedly in the poor neurological outcome group at 48h and 72h, and decreased significantly in the good group at the same time [△NSE 24 h-48 h: (37.3 ±28.7) ng/mL vs.(-10.7 ±12.1) ng/mL; △NSE 48 h-72h: (5.3 ±13.2) ng/mL vs.(-4.0 ±4.5 ng/mL), P<0.05].Over the 72 h of monitoring, the mean BIS values were lower in the poor outcome group compared to the good outcome group at 48 h [ (39.2 ±24.1) vs.(78.0 ±12.4); 72 h: (45.7 ±26.4) vs.(89.0 ±7.3), P<0.05].Conclusions The values of NSE and BIS were effective prognostic indicators for the neurological outcome of patients with MTH after CPR.

After the reform from "4+1" to "3+2",an undergraduate teaching model of clinical medicine,has been implemented in our university,higher demands are set on the training of students' abilities and creativity.This paper explored the basic medicine teaching from the perspectives of creative concepts,teaching staff,curriculum design and practice.

Objective To induce mice bone marrow(BM) mono-nuclear cells into dendritic cells(DC) in vitro,and then produce function vaccine of anti-myeloma by bone marrow derived dendritic cells(BM-DC).Methods Mono-nuclear cells separated from mice bone marrow were cultured in tissue culture plastics which supplemented granulocyte-macrophage clonystimulating factor(GM-CSF),IL-4.During the 8 days,there were numerous of mature DCs outgrown,and then fused with SP 2/0 myeloma cells in logarithmic growth phase cultured with 8-azaguaine by polyethylene(PEG).The resulting purified DC/myeloma hybrids were generated by selecting with hypoxanthine-aminopterin-thymidine(HAT).The specific anti-tumor activity was examined in vitro.Results Mono-nuclear cells derived from BM cultured by supplement propriate cytokines milieu in tissue culture plastics,and then exposed to lipopolysaccharide(LPS).There were plenty of mature DCs appear as early as day 8,and exhibit dramatic veils of cytoplasm and extensive dendrites in their surfaces,high express CD11c(83.19%),major histocompatibility complex(MHC)-Ⅱ(95.25%),CD86(89.24%),their capacity to stimulate primary T cell responses in mixed leukocyte reaction(MLR) would be shown strongly.Hybrids could grow well through PEG fusion and HAT selection.These hybrids could stimulate naive T cells into cytotoxic T-lymphocyte(CTLs) directed against SP 2/0 myeloma,and exhibit strong specific killed ability.Conclusions BM-DCs is fused with tumor cells ensure the tumor associated antigens could be processed and presented effectively,and stimulate specific anti-tumor immunity so that prevent or cure this kind of tumor.So it's feasible in practice to produce anti-tumor vaccine by BM-DCs.