Immune checkpoint blockade is a hot spot in treatment of cancers recently,and their effi-cacy in digestive cancer cannot been ignored.Nivolumab is superior to sorafenib in the terms of prolonging survival period for the patients with advanced live cancer.The effective rate of Pembrolizumab for advanced PD-L1 positive expression esophageal cancer can reach 30%.Nevertheless,Ipilumumab shows no significant efficacy in advanced pancreatic carcinoma.More researches are on the way,such as Avelumab in advanced gastric cancer,and Pembrolizumab in advanced esophageal squamous carcinoma.

Immunotherapy has become an important therapy for solid tumors,which is in addition to surgery,radiotherapy,chemotherapy and targeted therapy.However immune treatment mechanism is different from those previous treatment.The effect of immunotherapies is on the immune system and not directly on the tumor.The kinetics of immunotherapy is characterized by a cellular immune response followed by potential changes in tumor burden and survival period.They are not captured by the traditional World Health Organiza-tion (WHO)or the Response Evaluation Criteria in Solid Tumors (RECIST).New immune-related response criteria are defined which more comprehensively capture all response patters and gradually applied in clinical practice.

Objective To observe the effect of lactobacillus vaginal capsules and Kangfuxin liquid in the treatment of senile vaginitis and the influence on vaginal environment,thus to guide rational and effective treatment. Methods 80 patients with senile vaginitis were randomly divided into observation group and control group.40 cases in the control group were given ornidazole suppository,40 cases in the observation group were given lactobacillus vagi-nal capsules and Kangfuxin liquid on the basis of the control group.Both two groups had been treated for 7d.The symptoms and signs were observed before and after treatment.The vaginal secretions were taken for measuring vaginal lactobacilli by smear method.The pH in vaginal was detected,adverse events were recorded.All the patients were fol-lowed up for six months,the recurrence was observed.Results The total effective rate,the recurrence rate of 2 months after treatment,the recurrence rate of 4 months after treatment,the recurrence rate of 6 months after treat-ment of the observation group and control group were 97.5% vs 75.0%,0.0% vs 10.0%,2.5% vs 17.5% and 2.5% vs 22.5%,the differences were statistically significant(χ2 =4.211,5.000,7.314,all P <0.05).The improve-ment of genital itching,increased vaginal discharge,dysuria,vaginal congestion in the observation group were better than the control group(χ2 =5.00,4.872,5.475,5.333,all P <0.05).The pH values of vagina in the observation group and control group were (4.4 ±1.8),(5.5 ±2.1),there was statistically significant difference(t =5.386,P <0.01).The vaginal lactobacilli positive rate of the control group after treatment was 57.5%(23 /40),which of the observation group was 87.5% (35 /40 ),the difference was statistically significant (χ2 =9.028,P <0.01 ). Conclusion The method contained lactobacillus vaginal capsules and Kangfuxin liquid can balance the vaginal envi-ronment,improve symptoms and signs,reduce the rate of disease recurrence.

Objective To probe into the influencing factors and countermeasurses for clinical nursing teaching in pediatric department. Methods From June 2009 to June 2010, 86 nursing interns in pediatric department were selected, and a retrospective analysis was carried out. Results In the 86 interns in nursing practice, influencing factors of clinical nursing teaching included: 65 interns thought of department factors, accounting for 75.58%; 61 interns thought of nursing students factors, accounting for 70.93%; 59 interns thought of teacher factors, accounting for 68.60%; 57 interns thought of social factors, accounting for 66.28%. Conclusions Many factors influence pediatric clinical nursing teaching, we should strictly implement the rules and regulations and to actively take measures to comprehensively improve the quality of clinical practice for nursing students.

To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.
●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.
●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.
●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

ObjectiveTo investigate the inhibitory effect of peroxisome proliferator-activated receptor-?(PPAR?) agonist on mesangial cell(MC) proliferation and extracellular matrix expression induced by angiotensin Ⅱ(Ang Ⅱ).MethodsThe incorporation of 3H-thymidine(3H-TdR) and cell count were used as the measurement of MC proliferation.MC cell-cycle was analyzed by flow cytometry.Mouse primary MC was treated with various concentration of Ang Ⅱ(1,10,100 nmol/L) in the presence or Absence of N-acytosistin(NAC) or rosiglitazone.Transforming growth factor-?1(TGF-?1),plasminogen activator inhibitor-1(PAI-1),and fibronectin(FN) mRNA expression were determined by real time-PCR.Reactive oxygen species(ROS) production was measured by 2,7-dichlorofluorescein diacetate(DCFDA) fluorescence.Results1.One hundred nmol/L Ang Ⅱ increased 3H-TdR incorporation and cell number by 2.14 and 2.32 fold,respectively.Ang Ⅱ-induced MC proliferation was inhibited by PPAR? agonist rosiglitazone with dose-dependent manner in mouse MC.2.One hundred nmol/L Ang Ⅱ stimulation for 24 h induced 48% MC processed to S and G2/M phase.Rosiglitazone significantly blocked Ang Ⅱ increased cell number in S and G2/M phase.3.Rosiglitazone reduced Ang Ⅱ-induced TGF-?1,PAI-1,and FN mRNA expression with dose-dependent manner.4.One hundred nmol/L Ang Ⅱ stimulation for 60 min increased ROS production by 3.85 folds.Rosiglitazone significantly inhibited Ang Ⅱ-induced ROS production.Ten ?mol/L rosiglitazone almost completely blocked Ang Ⅱ-induced ROS production.ConclusionPPAR? agonist rosiglitazone could block Ang Ⅱ-induced MC proliferation and extracellular matrix expression via inhibition of ROS production.

Objective:To explore the cooradinative training model of postgraduate and and residency of nuclear medicine based on the ability promotion. Develop the learning of basic medical imaging knowledge, the training of clinical practice, the development of scientific research ability and the training of new technology and so on.Methods: Bibliometric analysis was used to analysis the domestic and overseas current situation and research hotspot about carrying out the training of clinical medicine and residency. Combing the existing problem and combined the characteristic of medical imaging, a training model based on ability enhancements be proposed and supporting system is constructed.Results:Search on the Wanfang Database, 170 literatures were obtained from 2007 to 2016 about training of postgraduates and residents of clinical medicine. The annual distribution was increased gradually, the articles number in 2016 was 4.3 times than in 2007. The research hotspots focus on the integration of medical postgraduate student and resident, clinical ability and cultivation of scientific research thinking ability , the penetration of new technology and the choices of research topics. Literature review shows the postgraduates of medical imaging faced the deficiency of anatomy and radiology knowledge, the capacity for scientific research, the training of new radiology technology. Proposed nuclear medicine postgraduate students and residency training cooradinative transformation of the new model and developed a corresponding training curriculum training system.Conclusion: Based on the background of capacity enhancement, the new model of postgraduate and clinicians training mechanism, the operation of collaborative transformation model, reasonable arrangements for the training and scientific research, the focused training, these methods could effectively satisfied both training needs. In order to develop the high-quality talent with both clinical experience and scientific research ability.

Nampt is a rate -limiting enzyme in the mammalian salvaging pathway for the synthesis of NAD that is involved in cell metabolism and proliferation .In recent years,growing research has elucidated that Nampt is correlated to various malignant tumors .It has a complex functions including regulation of energy metabo-lism and genome instability,promotion of proliferation and angiogenesis ,tumor-promoting inflammation and a-voidance of immune destruction .Recent reports indicate that Nampt is highly expressed in gliomas ,and it is close-ly related to the proliferation ,migration,invasion and prognosis of gliomas ,which will provide a new target for the glioma research and therapy .

BACKGROUND:Different embolic materials can be used for bronchial artery embolization in patients with pulmonary tuberculosis hemoptysis. Sodium alginate microspheres and gelatin sponge are two commonly used materials; however, there are relatively few related reports about the comparative analysis on the application effect of these two materials. OBJECTIVE:To investigate the clinical efficacy of sodium alginate microspheres for bronchial artery embolization on pulmonary tuberculosis hemoptysis. METHODS:Totaly 157 patients with pulmonary tuberculosis hemoptysis, including 98 male and 59 female patients, aged 22-75 years, were enroled and subjected to bronchial artery embolization using different embolic materials: sodium alginate microspheres group (n=74) and gelatin sponge group (n=83). During the 12 months of folow-up, the clinical curative effect, recurrence and complications condition of these two groups were observed. RESULTS AND CONCLUSION:The total effective rates of sodium alginate microspheres and gelatin sponge groups were respectively 91.19% and 81.93%, and there was a significant difference between groups (P < 0.05). The recurrence rates of sodium alginate microspheres and gelatin sponge groups were respectively 6.8% and 26.5%, and there was a significant difference between groups (P < 0.05). Additionaly, there was no significant difference in the complications between groups (P > 0.05). These results demonstrate that sodium alginate microspheres for bronchial artery embolization has a better result in the clinical treatment of pulmonary tuberculosis hemoptysis with a high clinicaly effective rate and low recurrence rate.

Objective To investigate the effects of nuciferine on hyperlipidemia in mice and to clarify the molecular mechanism. Methods Mice were divided into three groups according to the diet: normal control group ( n=10 ) , model control group (n=10), and the intervention group (n=10). The normal control group was treated with common diet (ANI-76A feed:12. 4% fat, 68. 8% carbohydrate, 18. 8% protein). The model control group was induced with high fat diet (37. 1% fat, 42. 4% carbohydrate, 20. 5% protein). The intervention group was supplemented with 0. 5% nuciferine based on high fat diet. The mice were allowed free access to food and water for a total of 10 weeks. Several indices were analyzed in the 3 groups, including the body weight, serum lipid, lipid metabolism key enzyme, oxidative stress and metabolic pathway. Results Our results suggested that the high-fat diet-induced animal models developed obesity and dyslipidemia (P<0. 05). The body weight [(33.97±3.46) g vs. (27. 62±2. 87) g] and the serum lipid[(2. 73±0. 26) g vs. (1. 91±0. 21) g] were significantly decreased in the intervention group compared to the model control group (P<0. 05), except for the hypertriglyceridemia (P>0.05).Theactivityofhepaticlipidmetabolismkeyenzymes[(4.15±1.26) U·mL-1vs.(9.01±1.34) U·mL-1] andthe activity of hepatic lipase and lipoprotein lipase[(8.12±3.07) U·mL-1 vs.(13.48±3.75) U·mL-1] were elevated.Oxidative stress was also affected by nuciferine (P<0. 05). Mechanism study suggested that lipid synthesis genes (like SREBP-1c, FAS, SCD-1 and PPAR gamma mRNA) were up-regulated by high fat diet (P<0. 05), and the lipid oxidation metabolism genes, PPARαand CPT-1a mRNA, were down-regulated (P<0. 05), while the intervention group treatment reversed these changes (P<0. 05). Conclusion Nuciferine can improve hyperlipidemia, which might be related to the regulation of enzyme activity, oxidative stress and the changes of lipid synthesis and oxidative metabolism.