Objective To identify the differential diagnosis value of CT in the pancreatic cystic disease.Methods 77 cases of pancreatic cystic disease diagnosed by CT scan were retrospectively analysed.Results CT recognized the different imaging features about cystic disease of malignant pancreatic tumor,metastatic cystic disease,begin-malignant pancreatic cystadenoma and acute/chronic pancreatitis.Conclusion Mastering the CT features of pancreatic cystic disease may give rise to the differential diagnosis,which is useful to the clinical decision.

Objective To retrospectivly analyze the value of Pap smear,liquid-based cells, colposcopy and colposcopic cervical biopsy in the diagnosis of cervical cancer. Methods 116 cases of cervical cancer were retrospectively analyzed, and the value of Pap smear,liquid-based cells ,colposcopy,and colposcopic cervical biopsy in the diagnosis of cervical cancer were investigated. Result 116 patients were pathologically diagnosed with cervical cancer before and after surgery. Pap smear was performed for 30 patients (25.9%) ,and 10 patients (33.3%) were detected with HSIL. Liquid-based cells was performed for47 patients (40.5%) ,and 25 patients (53.1%) were detected with HSIL. Colposcopy was performed for 99 patients (85.3%), and 75 patients (75.8 % ) were detected with HSIL or invasive cancer. Preoperative colposcopic biopsy was performed for 99 patients, and the pathological coincidence rate was 94.9%. There was no significant difference statistically between two cytology screening ( P ＞ 0.05 ). There was significant difference statistically between liquid-based cells and colposcopy ( P ＜ 0.01 ). There were significant differences statistically among liquid-based cells,colposcopy ,and colposcopic cervical biopsy ( P ＜0.01 ). Conclusion Cytology, colposcopy, colposcopic cervical biopsy could not be individually more complete and accurate detection of cervical cancer. Colposcopy,colposcopic biopsy than cytology had higher accurate rate of diagnosis of cervical cancer. A reasonable combination of multiple detection methods could improve the diagnostic accuracy of cervical cancer.

based on the theory of tree structure and followed the characteristics of medical talents growth,Wuxi No.2 People's Hospital carried out hospitalTalent Tree Project innovatively,which is to trained talents corresponding tobase-trunk-crown of a tree.The project has won the 2013 Human Resource Development Excellence Award of Asian hospital management awards.We fostered talents hierarchically according to the talents training echelon structure and this provided a way of guarantee and innovation for the sustainable development of hospital.

Background and purpose: High-dose chemotherapy followed by autologous stem cell transplantation (auto-HSCT) is considered as the ifrst line treatment for patients with relapse/refractory lymphoma after conventional chemotherapy. However, most of these patients still relapse the second time. The purpose of this study was to analyze the efifcacy of the consolidation chemotherapy after autologous stem cell transplantation (HSCT) refractory/relapse lymphoma in high risk. Methods:A total of 38 patients with relapsed/refractory lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were included, who were underwent auto-HSCT in our transplan-tation department from Jan. 2010 to Dec. 2013. In treatment group, 19 patients received 2 courses of consolidation che-motherapy after auto-HSCT every 2 to 3 months, with the regimen of mini-BEAM or modiifed mini-CBV. Another 19 patients had no chemotherapy after auto-HSCT as control group. Results:The median follow-up duration was 17.2 and 7.5 months in the treatment and control group respectively. The follow-up data demonstrated prolonged progression-free survival (PFS) in the treatment group than the control group [24.7 months vs 7.8 months, P=0.029 under intend-to-treat analysis ITT;24.7 months vs 5.2 months, P=0.01 under per protocol analysis(pp)]. There is also a trend of improved overall survival (OS) in the treatment group (P=0.055, ITT). Conclusion:Consolidation chemotherapy after auto-HSCT for refractory/relapsed lymphoma patients delay the relapse and tend to improve the overall relapse rate.

Objective To evaluate the efficacy of dezocine for prevention of postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty under remifentanil-based anesthesia.Methods Sixty-eight patients of both sexes, aged 65-85 yr, weighing 48-78 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , undergoing elective unilateral total knee arthroplasty under general anesthesia, were randomly divided into 2 groups (n =34 each) using a random number table: control group (group C) and dezocine group (group D).After induction of anesthesia, the patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with iv infusion of propofol 0.05-0.06 mg · kg-1 · min-1 and remifentanil 0.05-0.10 μg · kg-1 · min-1, and intermittent iv boluses of vecuronium 0.04 mg/kg.Dezocine 0.1 mg/kg was injected intravenously at 30 min before skin incision in group D.At 1 day before operation (T0) , and 1, 3, 5, 7 days after operation (T1 , T2, T3 , T4) , the blood samples from the central vein were collected for determination of serum cortisol (Cor), neuron specific enolase (NSE) and S-100β protein concentrations.Before operation, and 5 and 7 days after operation, the patients' cognitive function was assessed using Mini-Mental State Examination, and the occurrence of POCD was recorded.Results Compared with the baseline value at T0, the serum Cor, NSE and S-100β protein concentrations were significantly increased at T1-3, and MMSE scores were decreased at T3,4 in the two groups.Compared with group C, the serum Cot, NSE and S-100β protein concentrations were significantly decreased at T1-4, and Mini-Mental State Examination scores were increased at 5 and 7 days after operation, and the incidence of POCD was decreased in group D.Conclusion Dezocine 0.1 mg/kg intravenously injected at 30 min before skin incision can prevent the occurrence of POCD in elderly patients undergoing total knee arthroplasty under remifentanil-based anesthesia.

The First Affiliated Hospital of Nanjing Medical University has adopted a strategy of brand development in the process of continuing medical education.Given the different recipients,the First Affiliated Hospital of Nanjing Medical University has established four types of brand-based education modes,namely Jinling high-level forum of clinical medicine,hospital management school,management salon,and clinical case discussion in English.The influence and competitiveness of the brand of hospital continuing education should be elevated through the following methods:adhering to the brand development orientation-to fulfill the public responsibility and cultivate medical talents; establishing appraisal mechanism of continuing medical education; transforming thinking of management department; relying on new media propaganda and expanding domestic and international communication.

T cell immunoglobulin and mucin domain 3 (Tim-3) is well known to negatively regulate T cells responses, but its role in burn-induced T cells immune suppression remains unclear. In the present study, in order to identify the relationship between Tim-3 expression and post-burn T cells immune suppression, C57BL/6 mice were subjected to burn injury or sham injury, and the liver and spleen were harvested at the day 1 after operation. The expression level of Tim-3 on hepatic or splenic T cells and the functional properties of Tim-3(+) T cells were evaluated. It was found burn injury induced dramatically elevated Tim-3 expression on both hepatic and splenic CD4(+) and CD8(+) T cells in contrast with the post-burn depletion of T cells. Furthermore, Tim-3 expression was correlated with the suppressive phenotype of T cells following burn injury, including increased expression of anti-inflammatory cytokine IL-10, decreased expression of pro-inflammatory cytokines IFN-γ and TNF-α, reduced T cell proliferation and elevated co-expression of Tim-3 and PD-1. Moreover, Tim-3(+) T cells subsets were more prone to spontaneous apoptosis than Tim-3(-) T cells subsets. Our findings reinforce the idea that the up-regulated expression of Tim-3 on T cells after burn injury plays an important role in the development and maintenance of burn-induced T cell immune suppression.

AIM To testify the special cytotoxicity of TGF? SAP on proliferating vascular smooth muscle cells and endothelial cells. METHODS Conjugation of saporin to TGF? was accomplished after derivatization of saporin and TGF? with N succinimidyl 3 (2 pyridyldithio) proprionate. Cytotoxicity assays were measured by cell count. The studies of influence of TGF? SAP on values of thymidine and leucine incorporation into SMCs and ECs were measured by 3H thymidine uptake and 3H leucine uptake, respectively. RESULTS Cytotoxicity assays testified TGF? SAP conjugate could inhibit remarkably proliferation of SMCs in culture. The values of thymidine of TGF? SAP group (1?10 -9 mol?L -1 and 1?10 -7 mol?L -1 ) in comparison significantly decreased to 60 9% and 56 0% of the control group respectively, suggesting that cellular DNA synthesis obviously decreased as TGF? SAP was added. But saporin did not affect cellular DNA synthesis at higher level. The rate of 3H leucine incorporation of TGF? SAP group significantly decreased to 47 3% of the control group, suggesting that SMCs protein synthesis obviously decreased as TGF? SAP was added. But TGF? SAP at the same level did not affect DNA synthesis and protein synthesis of ECs compared with the control group. CONCLUSION TGF? SAP possesses the more effective cytotoxicity than saporin and the more specific citotoxicity on proliferating vascular smooth muscle cells than on proliferating endothelial cells.

Objective The cyst excision is considered as priority management of the female paraurethral cyst.The purpose of this present study was to explore the feasibility and safety of the two-step excision with treatment for the female paraurethral cyst.Methods Twenty eight consecutive women with paraurethral cyst underwent paraurethral cyst removal were enrolled retrospectively in this study from October 1,2005 to August 12,2008 in Urology Department of West China Hospital.Results All cases were followedup from 6 months to 2 years,no recurrence occurred.No complications such as urethral stricture and urethralvaginal fistula were found.Conclusions The 2-step excision is the reference technique for cure of female paraurethral cyst.Urethra injury was avoided efficiently,because anatomical relationship between cyst and urethra could be clearer when the technique of 2-step excision was applied.

Objective To provide a device and an effective method for tail vein injection in mice. Methods Doing the tail vein injection in mice with the self-designed device which is consisted of constant temperature part, lighting part and holding part.The difficulty and time of injection with and without the device were compared.Results It was faster and more accurate to perform the tail vein injection in mice with this self-designed device.Conclusion Using this self-designed device can significantly improve the efficiency and save the injection time.