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Objective:To evaluate the sedative efficacy of S-ketamine combined with propofol for MRI examination in pediatric patients.Methods:One hundred children of both sexes, aged 1-6 yr, weighing 10-30 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, who underwent MRI from February to June 2021, were selected and divided into 2 groups ( n=50 each) by a random number table method: propofol group (P group) and S-ketamine plus propofol group (K+ P group). Anesthesia induction: propofol 2.5 mg/kg was intravenously injected in group P, and S-ketamine 0.5 mg/kg and propofol 1.5 mg/kg were intravenously injected in group K+ P.Anesthesia maintenance: propofol 100 μg·kg -1·min -1 was intravenously infused, and the infusion rate of propofol was adjusted to maintain Ramsay sedation score ≥5.Propofol 0.5-1.0 mg/kg was intravenously injected and/or increasing the infusion rate of propofol when moderate and severe movement occurred.The quality of MRI images was evaluated during the examination, and the occurrence and degree of movement, airway-related adverse events (hypoxemia, apnea, upper airway obstruction, hypersalivation), hypotension and bradycardia were recorded.The average infusion rate, consumption of additional propofol for intravenous administration and total consumption of propofol were recorded.The emergence time and time of anesthesia recovery room stay were recorded.The occurrence of adverse events (vomiting, diplopia and agitation) and the parents′ satisfaction with sedative efficacy and recovery were recorded during observation in the recovery room. Results:Compared with group P, the average infusion rate of propofol, total consumption of propofol, airway-related adverse events and incidence of hypotension and bradycardia were significantly decreased ( P<0.05), and no significant change was found in the incidence and degree of body movement, quality of MRI images, emergence time and time of anesthesia recovery room stay and incidence of adverse events during recovery from anesthesia in group K+ P ( P>0.05). Conclusion:S-ketamine combined with propofol can be safely and effectively used in MRI examination in pediatric patients.
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Insomnia, as the most common sleep disorder in the population, is often accompanied by depression, anxiety and other mental diseases, which can lead to impaired social and occupational functions as well as decreased quality of life. There is growing evidence that insomnia may be a risk factor for stroke. On the other hand, the incidence of insomnia in stroke patients is significantly higher than that in the general population. Correctly understanding the bidirectional relationship between insomnia and stroke can make clinicians pay more attention to insomnia and its treatment, and increase clinical benefit in patients with stroke and insomnia.
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Objective@#To investigate the relationship between dietary polyunsaturated fatty acid (PUFA) intake and blood lipid, C-reactive protein (CRP) and homocysteine (Hcy) in patients with acute ischemic stroke or transient ischemic attack (TIA).@*Methods@#Patients with acute ischemic stroke or TIA were enrolled consecutively from Nanjing Stroke Registry Program. The total dietary PUFA intake level was assessed by the food semi-quantitative frequency questionnaire. Venous blood samples were collected in the morning of the day after admission to the hospital to detect the levels of serum total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, Hcy, and CRP. According to the median level of total PUFA intake, the patients were divided into low PUFA group and high PUFA group. The relationship between PUFA intake and blood lipid, CRP and Hcy was analyzed by Spearman correlation analysis, and multiple linear regression analysis was used to determine the independent correlation.@*Results@#A total of 170 patients (85.1%) with acute ischemic stroke and 31 patients with TIA (14.9%) were enrolled. Their age was 62.9±14.1 years, 143 were males (71.1%), and the median PUFA daily intake was 12.8 g (interquartile range: 8.05-17.5 g). Compared with the high PUFA group (n=100), patients in the low PUFA group (n=101) were older, serum high-density lipoprotein cholesterol levels were lower, and CRP and Hcy levels were higher. The above differences were statistically significant (all P<0.05). Spearman correlation analysis showed that total dietary PUFA intake was significantly negatively correlated with the serum CRP (r=-0.24, P=0.001) and Hcy (r=-0.17, P=0.013) levels, and there was no significant correlation with the blood lipid levels. Multiple linear regression analysis showed that CRP was significantly negatively correlated with PUFA intake after adjusting for confounding factors (B=-0.28, P=0.012).@*Conclusions@#Dietary PUFA intake in patients with acute ischemic stroke or TIA may affect blood metabolism index and oxidative stress index. It is necessary to adjust the dietary structure of patients with low PUFA intake to reduce the risk of stroke recurrence.
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Objective To investigate the clinical application of acupuncture combined with metformin or the treatment of diabetes at the early stage.Methods According to the random table method,123 patients with diabetes at the early stage were divided into control group (n=61) and the treatment group (n=62).The patients in the control group were treated with metformin,while the patients in the treatment group were treated with acupuncture combined with metformin.Two groups of patients were treated for 12 weeks.The clinical total effective rate of two groups of patients after treatment was counted.The FPG,HbA1c,FINS,FCP,TG,TC,LDL-C,HDL-C,LEP,GLP-1,RETN,HOMA-IR and ISI of the two groups before and after treatment were compared.Results The total effective rate of treatment group was 91.9％ (57/62),while the control group was 65.6％ (40/61),and the difference between two groups was statistically significant (x2=12.818,P＜0.01).After treatment,the FPG,HbA1c,FINS.FCP,HOMA-IR,ISI,TG,TC,LDL-C,LEP,RETN of treatment group were significantly lower than those of the control group (t were 14.149,14.301,4.254,7.552,9.470,11.032,9.993,12.000,11.802,5.385,9.121,P＜0.01),while the HDL-C,GLP-I of treatment group were significantly higher than those of the control group (t were 3.402,14.680,P＜0.01).Conclusions Acupuncture combined with metformin or the treatment of diabetes at the early stage has a good efficacy,can correct the disorder of glucose and lipid,improve the insulin resistance.
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Objective To explore the correlation between thyroid function profiles and early onset of insomnia in patients with acute ischemic stroke. Methods This longitudinal observational cohort study prospectively enrolled 276 acute ischemic stroke patients admitted to the Department of Neurology,Jinling Hospital,Nanjing Medical University from May 2018 to May 2019. According to the diagnostic criteria for insomnia in international classification of sleep disorders, 3rd edition ( ICSD-3 ), stroke patients were divided into insomnia group (64patients) and non-insomnia group (212patients). Univariate analysis and multivariate Logistic regression analysis were used to investigate the correlation between thyroid function profiles and early onset insomnia in early stroke and the difference of TSH levels between insomnia group and non-insomnia group in subgroup of patients with normal TSH. Results A total of 276 patients with acute ischemic stroke were included in the study. There were 64 patients (23.2%) in the insomnia group and 212 patients (76. 8% ) in the non-insomnia group. Serum TSH levels were higher in the insomnia group compared with the non-insomnia group (1.9 [ 1. 0, 3. 7[ mU/L is. 1. 6 [ 1. 0, 2.4[ mU/L, P = 0. 044). After adjusting for confounding factors by multivariate Logistic regression analysis,the results show that higher TSH level in serum was an independent risk factor for early new insomnia in patients with acute ischemic stroke (0/?, 1.214,95% CI 1.016-1.449,/> = 0. 032). In addition,in the subgroup with normal TSH,serum TSH levels in the insomnia group were still higher than those in the non-insomnia group( 1.8[ 1. 1, 2.8] mU/L vs. 1. 6[ 1. 1,2. 3] mU/L) ,and the multivariate regression analysis showed that the relatively high T5H level was an independent of risk factor for early insomnia (OR, 1. 635,95% CI 1. 047-2. 554, I' =0. 031). Conclusion Serum TSH is associated with early onset insomnia in acute ischemic stroke, suggesting that the thyroid function axis may play a role in new insomnia in early stroke.
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Objective To investigate the relationship between dietary polyunsaturated fatty acid (PUFA) intake and blood lipid,C-reactive protein (CRP) and homocysteine (Hcy) in patients with acute ischemic stroke or transient ischemic attack (TIA).Methods Patients with acute ischemic stroke or TIA were enrolled consecutively from Nanjing Stroke Registry Program.The total dietary PUFA intake level was assessed by the food semi-quantitative frequency questionnaire.Venous blood samples were collected in the morning of the day after admission to the hospital to detect the levels of serum total cholesteroI,triacylglycerol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,Hcy,and CRP.According to the median level of total PUFA intake,the patients were divided into low PUFA group and high PUFA group.The rehtionship between PUFA intake and blood lipid,CRP and Hcy was analyzed by Spearman correhtion analysis,and multiple linear regression analysis was used to determine the independent correhtion.Results A total of 170 patients (85.1％) with acute ischemic stroke and 31 patients with TIA (14.9％) were enrolled.Their age was 62.9 ± 14.1 years,143 were males (71.1％),and the median PUFA daily intake was 12.8 g (interquartile range:8.05-17.5 g).Compared with the high PUFA group (n =100),patients in the low PUFA group (n =101) were older,serum high-density lipoprotein cholesterol levels were lower,and CRP and Hcy levels were higher.The above differences were statistically significant (all P ＜ 0.05).Spearman correlation analysis showed that total dietary PUFA intake was significantly negatively correhted with the serum CRP (r =-0.24,P =0.001) and Hey (r =-0.17,P =0.013) levels,and there was no significant correlation with the blood lipid levels.Multiple linear regression analysis showed that CRP was significantly negatively correlated with PUFA intake after adjusting for confounding factors (B =-0.28,P =0.012).Conclusions Dietary PUFA intake in patients with acute ischemic stroke or TIA may affect blood metabolism index and oxidative stress index.It is necessary to adjust the dietary structure of patients with low PUFA intake to reduce the risk of stroke recurrence.
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Objective:To analyze pharmaceutical procurement model of hospital, and explore better pharmaceutical procurement model so as to suit the development of modern hospital.Methods: Combined with the current situation of pharmaceutical procurement in domestic medical organization in recent years to analyze the current problems that existed in pharmaceutical procurement of hospital management.Results: Aimed at the problems that existed in procurement management model in current hospital, the reasonable suggestions have been proposed, and these suggestions have provided reference and experience forpharmaceutical management and procurement in hospital.Conclusion: Pharmaceutical procurement is the material basis of pharmaceutical supply of pharmaceutical trading enterprise, and it is the start point of pharmaceutical circulation and distribution, and it also is the first important step. Especially, aimed at the institutional reform of separating pharmacy from clinic in Beijing, the normalization of pharmaceutical procurement management will be very important effect in working practice.
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In many pathogens infection,especially virus,antibody-dependent enhancement(ADE) can aggravate the infection and lead to severe diseases.In this immunopathological phenomenon,virus-specific antibodies enhance the entry of virus into monocytes,macrophages and granulocytic cells and even the replication of virus through different mechanism.This phenomenon has been reported in numerous pathogens including virus,bacteria and parasite and the mechanisms of ADE vary from different species.Further study of ADE can promote the vaccine research and development to make the most use of vaccine and prevent human body from pathogens,which will be helpful to control the spread of pathogens including Zika virus.In the present review,we review the research progress of ADE mechanism in recent years,including antibodies mediating,receptors mediating,complement mediating,viral proteins mediating and cellular mediating ADE.In addition,dengue virus,human immunodeficiency virus,Coxsackie virus,Ebola virus,Zika virus and other pathogens will be illustrated respectively.This review provides insights on the different mechanism of ADE in different pathogens.
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Acute kidney injury (AKI) is the complex clinical syndrome attributed to multiple causes and risk factors, which is characterized by an abrupt loss of renal function. Metabonomics, recently advances in the field of omics, is the nontargeted measurement of all of the low-molecularweight compounds that appear in a particular cell, tissue, organ or biofluid in a living organism. Compared to genomics, transcriptomics and proteomics,metabonomics has its unique advantages, including fewer metabolites than genes, transcripts and proteins, the most accurate predictors of the signature of the actual processes, easy access to biofluids. Thus, metabonomics makes it possible to find new biomarkers for AKI on early diagnosis, identifying new metabolic pathways, finding new targets for drug therapy and individual medical treatment.
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Objective:To provide informational and personalized health service platform for the current number of chronic diseases and health groups. Methods:a variety of portable devices physiological data were collected to transmit to the remote health monitoring platform, making the service with strong mobility for home care, postoperative care and patient care whenever and wherever needed to provide the best care service model, so that medical and health care is no longer subject to the constraints of time, hospitals and other fixed places. Results: Through a variety of wireless transmission technology and the intelligent terminal and regional health data center, it can be further mining, analysis and storage for the data information, and provide diagnostic advice. It can effectively alleviate the tension of medical resources. Conclusion:The establishment of remote health monitoring platform can alert doctors and relatives when data is abnormal to win time for rescue. It can effectively manage the disease treatment, prevention and rehabilitation.
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Objective To observe the expression profiles of miR-200b/c and their targets ZEB1/2 in early pulmonary fibrosis caused by acute lung injury induced by lipopolysaccharide in mice.Methods Early pulmonary fibrosis caused by acute lung injury is built via a lipopolysaccharide three-hit regimen.Mice were sacrificed at post-injective day 3,7,14,21 respectively and the lung tissue specimens were collected.The lung tissue sections were stained with HE and Masson staining and pathological changes were observed by optical microscope.The expression profiles of miR-200b,miR-200c,ZEB1 mRNA and ZEB2 mRNA were detected by real-time PCR.Western blot was utilized to detect the levels of ZEB1,ZEB2,E-cadherin,Vimentin,α-SMA proteins.Results (1) pathological findings:compared with the control group,the collagen fibers deposited on on the third day after LPS treatment and pulmonary fibrosis gradually worsened;(2) Real time-PCR results:With the aggravation of pulmonary fibrosis,miR-200b and miR-200c levels were declined and the levels of miR-200b/c at post-injective day 7,14,21 were significantly lower than that of control group (P＜0.01).ZEB1 mRNA and ZEB2 mRNA levels were gradually increased in the process of pulmonary fibrosis and the increased magnitude of ZEB2 mRNA was more significant than that of ZEB1 mRNA;(3) Western blot results:ZEB1 and ZEB2 protein levels were also gradually increased,consistent with their mRNA levels and the expression of E-cadherin protein was decreased while Vimentin and oα-SMA protein levels increased with the evolution of pulmonary fibrosis caused by acute lung injury.Conclusion miR-200b and miR-200c promote epithelial-mesenchymal transition by inhibiting their targets ZEB1/2 in early pulmonary fibrosis caused by acute lung injury induced by LPS.
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Objective:In view of the present hospital medical equipment management problems, we designed a management information system based on RFID. It implements the medical equipment's scientific, standardized, intelligent management objectives.Methods: By optimizing the work flow, improve the regulatory system, the introduction of information management and other means, using RFID technology to complete the full cycle of intelligent management of medical devices.Results: A design scheme of the system can realize a full range of monitoring and management of medical equipment planning, procurement, storage, supply, maintenance and other work of the organization and management.Conclusion: Advantages and use of RFID technology management system will certainly change management mode of medical equipment, and adapt hospital equipment management to the hospital medical treatment, teaching, scientific research and other work, become an important task of informative hospital.
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Objective: For information collection and processing problems currently existing hospital medical equipment management, we design a system design scheme based on RFID technology to achieve the implementation of intelligent management and data processing. Methods:RFID technology is through the electronic tag, reader, the application software system to accomplish the working process of the RFID system. Results:System design scheme can realize comprehensive monitoring and management of hospital medical equipment;realize information management of hospital equipment. Conclusion:The advantage and the use value of RFID technology will change management mode of medical equipment, and bring new opportunities and challenges to the medical equipment management.
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Objective To explore the therapy effect of candesartan plus CSDP on elderly hypertensive patients with renal dysfunction.Methods Eighty elderly patients with essential hypertension and renal dysfunction were selected as our subjects.All subjects were randomly divided into candesartan group and candesartan + CSDP group,every group for 40 subjects.Patients in candesartan group were treated with 4 mg candesartan once per day for 6 months.Patients in candesartan + CSDP group were given CSDP 10 capsules three times / day beside 4 mg candesartan,once per day for 6 months.The levels of Cr,BUN,Ccr changes were measured.Results Two therapy strategies can decrease blood pressure and the decrease rate of blood pressure in candesartan + CSDP group was higher than that of candesartan group.The level of Cr,BUN in patients with candesartan + CSDP group after treatment performing were (104.6 ± 6.5) μmol/L,(6.21 ± 4.80) mmol/L,lower than that in before treatment (196.8 ± 2.6) μ mol/L,(9.84 ± 3.20) mmol/L.And the Ccr increased from (58.1 ± 4.9)ml/min to (117.2 ± 6.4)ml/min.The differences were significant (t =2.213,2.302,2.136,P ＜ 0.05).However the differences between before and after treatment with only candesartan treat weren't significant (P ＜ 0.05).Conclusion Candesartan + CSDP might show a synergistic effect compared with candesartan in term of curing elderly hypertensive patients with renal dysfunction.
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Objective To explore the clinical effect of CSDP combined with losartan treatment on type 2 diabetic nephropathy with stage Ⅲ.Methods Sixty patients suffered from type 2 diabetic nephropathy with stage Ⅲ were recruited as our subjects.They were randomly divided into Candesartan group and Candesartan + CSDP group,each for 30 patients.Patient in Candesartan + CSDP group were administrated with candesartan 4 mg,once per day,the CSDP 15 capsules and three times / day for 3 months.Patients in Candesartan group were given:candesartan 4 mg once/day for 3 months.The level of urinary albumin,serum urea nitrogen (BUN) and creatinine (Cr) were measured of subjects before and after treatment.Results The levels of BUN,Cr were lower after any treatment than before treatment in 2 groups.The difference of BUN,Cr in Candesartan + CSDP group were(-14.6 ± 8) mg/L,(-11.9 ± 3.3) μmmol/L,(-0.7 ± 0.2) mmol/L,higher than that of Candesartan group (-7.1 ± 7.8) mg/L,(-8.5 ± 0.8) μmol/L,(-0.4 ± 0.1) mmol/L] (P ＜ 0.01).Conclusion The treatment strategy of Candesartan joint CSDP can be method regarding of reducing urinary albumin and BUN,Cr in patients of type 2 diabetic nephropathy with stage Ⅲ.
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Objective: To investigate the non-specific and inaccurate amplification in cases of highly similar sequences among family members and the length heterogeneity of mature microRNA ( miRNA) ,and find a condition that discriminates maximally among similar miRNA family members and detects the accurate expression level of miRNAs. Methods: Primers with their mismatches and/or 3' end at different positions were designed. Amplification efficiencies were compared using matched and various mismatched primers by RNA-tailing and primer-extension RT-PCR at different annealing temperatures. Expression levels of several miRNAs in mouse brain were compared using miRNA specific primers with different termini. Results: Raising annealing temperatures 12℃-14℃above the T_m of the primers maximally increased amplification specificity without sacrificing sensitivity. Primers designed with their termini on or near variant positions could efficiently discriminate between miRNA isoforms. Using primers that terminated before the end of the mature miRNA did not miss the detection of shorter mature miRNA and provided accurate expression levels. Conclusion: Careful primer design and higher annealing temperature can increase specificity and accuracy of real time PCR miRNA detection.
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Medical maintenance,content,quality control of medical equipment and their mutual relationships are discussed.It is to set up the content requirement and controlling way for equipment repairing together with their relationships using the theory and method of modern management science to direct,organize,control and coordinate the repairing work of medical equipment.It is also expected to predict,regulate and check every link of the repairing course so as to establish good quality controlling and management system for optimum repairing effect and economic benefit.This is profound to promote the comprehensive improvement of the quality of medical equipment.
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Objective:To examine global expression levels of microRNAs(miRNAs) in mouse cerebrum and to provide an important basis for detailed studies of individual miRNAs,their target genes,the miRNA-related regulatory networks in the mammalian central nervous system,and their implications in diseases.Methods:Low molecular weight RNA from cerebrum of five C57BL/6J mice were tailed and reverse transcribed by extended RT-primer.miRNA primers were carefully designed and arrayed on plates according to the Tm of each primer.PCR was carried out at different annealing temperatures using a gradient real-time PCR instrument.The relative expression level of each miRNA was calculated using 5sRNA for normalization.Results:Among the 285 miRNAs detected,260 were positive with varying abundance.Their frequency distribution was approximately a normal distribution.The expression levels of most miRNAs were in accordance with previously published results by microarray.However,the positive rate was higher than that detected by microarray.miRNAs originating from the same hairpin precursors expressed at similar or significantly different levels.Clusters of proximal miRNAs were similar or quite different in abundance.It is suggested that the fate of miRNA after transcription determined their abundance.Conclusion:Using the RNA-tailing and primer-extension PCR array method,we obtained expression profile of miRNA in mouse cerebrum,especially the relative expression data of many low abundant miRNA in mouse cerebrum,which will be of special help for studying the fine-tuning function of low-level miRNAs.
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Objective: To further study the effect of apoptin in inducing cancer cell specific apoptosis and the possible applications in cancer therapy. Methods: Apoptin gene was amplified by PCR and inserted into pcDNA3.1(+) with a FLAG tag in front of the multi-cloning-site. Apoptin gene with the FLAG tag was sub-cloned into an adenovirus vector. Several cancer cell lines were transfected with pcDNA3. 1/FLAG/apoptin or infected with apoptin containing recombinant adenoviruses to study the morphologic changes. Ad/apoptin infected cells were also analyzed by flowcytometry after staining with PI. Results: Expressed apoptin was localized in the nucleus of cancer cells. Chromatin condensation occurred 2 or 3 days after Ad/apoptin(+) infection. Cell number in G 2-M phase increased dramatically after Ad/apoptin(+) infection. Conclusion: Apoptin can induce cell cycle G 2-M arrest and chromatin condensation in cancer cells.
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Objective: To study the immunotherapeutic effect on the esopgageal adenocarcinoma mediated by gp96-peptide complexes isolated from the same kind of tumor. Methods: gp96- peptide complexes were purified from nude mice tumors burdened by subcutaneous injection of human esophageal adenocarcinoma cell line SEG-1 . gp96-peptide complexes were carried by the dendritic cells(DC) induced from human peripheral blood mononuclear cells to prepare gp96-DC vaccine. The proliferation of lymphocytes was tested with trypan-blue stain. The quantity of interferon-?(IFN-?) released from cytotoxic T lymphocytes (CTL) was detected with ELISA method. The killing effect of CTL on target cell SEG-1 was measured with MTT. Results: We obtained 120 ?g gp96 from 55 g tumor tissue. DC, gp96, and gp96-DC all could elicit the proliferation of lymphocytes and make them becoming into CTL which released IFN-? and showed different degrees of killing effect on target cell SEG-1. gp96-DC has the strongest eliciting effect among them. At the ratio of E(effect) to T(target) as 40∶1,the killing rate was 68%.No significant difference between the effects of CTL induced by DC alone and of lymphocytes without specific antigen on SEG-1 and K562 cells. Conclusion: The gp96-peptide complexes from tumors can improve the effect of eliciting lymphocyte proliferation of DC and make the lymphocyte becoming into CTL more effectively.These CTLs show prominent killing effect on the target tumor cells.