Immune checkpoint inhibitors have become an important alternative for advanced non-small cell lung cancer (NSCLC) patients to surgery, chemotherapy, radiotherapy and targeted therapy. Monoclonal antibodies directed against immune checkpoint have shown better results in the application of first- or second-line treatment of NSCLC and for both squamous and non-squamous cell carcinoma patients, especially for those with positive PD-L1 tumor cells. Some comments will be made in present paper about the efficacy, biomarker, combined therapy and the resistant mechanism of immune checkpoint inhibitors.

Objective To investigate the effect of ginsenoside-Rgl on paraurethral fascia fibroblastsmultiplication and the expression of proliferation cell nuclear antigen (PCNA) of stress urinary incontinence(SUI) women in vitro. Methods Specimens of human paraurethral fascia were obtained from 4 SUI womenduring tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator (TVT-O) procedure.Fibroblasts were isolated and cultured by outgrowth technique. After reaching confluency fibroblasts weresubcultured every 5 days and cells after passage number 3 to 5 were used for assessment. The paraurethralfascia fibroblasts were treated with ginsenoside-Rgl at different concentrations (5, 10, 20 μmol/L) andfibroblnsts without Rgl were used as controL The multiplication conditions of paraurethral fascia fibroblastswere respectively detected by methyl thiazolyl tetrazolium (MTr) assay and the expression of PCNA byhistochemistry. Results ( 1 ) Compared with the control group, the growth rate of cells treated with differentconcentrations of Rgl after 72h [ (29±5 )%, (40±5 )%, (26±4)% respectively ] was significantly higher(P<0.01). (2)Compared with the control group, the stimulatory effect of Rgl on fibroblast growth wassignificant at 24 h (P<0.01), and peaked at 72 hi (29±5)% ,(40±5)%, (26±4)% respectively, P<0.01]. (3)Compared with the control group(28.77% ), there was a significant increase of PCNA-positivecells (P<0.01) after 48 h treatment with different concentrations of Rgl (49.24%, 83.48%, 54.50%respectively). Conclusion The results indicate that, at least in vitro, fibroblasts from paraurethral fasciataken from women suffering from SUI are able to proliferate after

Central nervous system ( CNS) injuries, such as cerebral ischemia, traumatic brain injury (TBI), and spinal cord injury (SCI), are often accompanied by complex pathological changes, and could lead to a variety of other neurological diseases.Neurons and glial cells are precisely regulated by many genes.MicroRNA ( miRNA ) are endogenous molecules discovered in recent years that regulate post transcriptional gene expression.They are highly expressed in the central nervous system and abnormal expressed under pathological conditions.They are involved in regulating variety of pathological processes after CNS injuries, and are CNS disease potential biomarkers.

Objective To investigate altered levels and clinical significance of serum miR-133a in patients with acute coronary syndrome ( ACS ) and stable coronary artery disease ( SCAD ) .Methods Retrospective study.Serum miR-133a levels were determined by TaqMan quantitative reverse-transcription PCR assay in 64 ACS, 62 SCAD patients who were admitted to Jinling Hospital from October 2011 to October 2012 and 70 normal controls who had contemporaneously visited Jinling Hospital for routine examination .The ACS and SCAD patients were diagnosed according to the European Society of Cardiology guidelines .Serum lipid/lipoprotein profiles , myonecrosis biomarkers and Gensini scores were also analyzed .The area under curve ( AUC) and 95%confidence interval ( CI) were calculated using ROC analyses .The odds ratio ( OR) and 95%CI were calculated using the multivariate logistic regression analyses .Results Compared with the controls [ΔCt:1.00 ±0.05], serum miR-133a levels were significantly increased in both ACS [ΔCt:2.34 ±0.24] (t=6.059, P<0.001) and SCAD [ΔCt:1.45 ±0.13] (t=3.265, P=0.001) patients.The miR-133a levels in ACS patients were significantly higher than in SCAD patients (t=3.133, P=0.002). Serum miR-133a were positively correlated with levels of creatine kinase MB ( CK-MB) ( r=0.402, P<0.001), cardiac troponin I (cTNI) (r=0.410, P=0.001) and Gensini scores (r=0.438, P<0.001). ROC curve analyses showed that the AUC of miR-133a for differentiating coronary artery disease (CAD) and controls was 0.717 (95%CI:0.645-0.788, P<0.001) and the AUC for differentiating ACS and SCAD was 0.667 (95% CI:0.573-0.761, P=0.001).Logistic regression analyses revealed that high miR-133a levels were closely associated with the presence of ACS ( OR=6.00, 95% CI:1.93 -18.67, P=0.002) and SCAD (OR=2.81, 95%CI:1.03-7.68, P=0.044), and also had statistical significance for differentiating ACS and SCAD (OR=2.13, 95% CI:1.20-3.78, P=0.010), after adjustment for the age, gender and serum lipid/lipoprotein levels.Conclusions Serum miR-133a levels were significantly elevated in CAD patients, and ACS patients exhibited the more significant increase .Serum miR-133a may be function as the potential biomarker for the disease assessment and judgement .

Definite elements is the first step of systemic analysis. Quality of thesis was determined by a combination of three factors in non-substantial dimension: ability,attitude and system. They affect the quality of undergraduate thesis in health management through different mechanisms respectively,such as selection and externalization of ability,power,adaptation,adjustment and defense of attitude,guide and regulation of system.

Objective To analyze the clinical characteristics and therapy of Nocardia infection, and provide reference for clinical practice.Methods Patients with positive specimen culture of Nocardia from May 2014 to June 2016 were surveyed retrospectively, the body status, clinical features, therapeutic regimen, and prognosis were analyzed.Results A total of 10 cases of Nocardia infection were surveyed, there were 7 males and 3 females;average age was (49.90+13.75) years old.Nocardia infection occurred mostly in population with impaired immune status or underlying diseases, the main infection site was lung, compound sulfamethoxazole was the first choice drug for treatment of infection, amikacin, imipenem/cilastatin and so on were alternative choice according to disease condition, 8 patients all improved after therapy.Conclusion The diagnosis made on the basis of microbiological examination, imaging, and pathological examination, combined with comprehensive judgment according to risk factors of Nocardia infection, patient can be treated timely and rationally, and the prognosis is better.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus)in patients with metabolic syndrome combined with sensorineural deafness using 1 H magnetic resonance spectroscopy (1 H-MRS),and to find out the early warning indicators of sensorineural deafness in patients with metabolic syndrome.Methods The pure tone audiometry (PTA)was performed in 142 pa-tients with metabolic syndrome (diagnosed by endocrinology department),and 15 healthy subjects as the control group.The patients were divided into four groups:the metabolic syndrome group;the metabolic syndrome group with unilateral,the bilateral deafness group,and the control group.Cerebral metabolism was studied by assessing the ratios of nitro-acetyl aspartate contrast to choline (NAA/Cho)as well as to creatine (NAA/Cr),myo-inosi-tol to creatine (mI/Cr)and choline to creatine (Cho/Cr)ratios in the auditory cortical separately in these groups. ROC curves were made for those metabolism markers to find the best diagnostic threshold.Results Significantly lower values of NAA/Cho ratio and higher values of Cho/Cr were observed in metabolic syndrome in the control group (P<0.05),Cho/Cr higher than those (P<0.05).NAA/Cho ratios in the injured and uninjured auditory cortex of MS with unilateral deafness were significantly lower than those in the control group (P<0.05).A self-comparison was made between the inj ured and uninj ured auditory cortex,the result showed that NAA/Cho ratio had significant differences.All of the metabolisms were tested by the curve of ROC.The area of NAA/Cho under the ROC curve was 81%,which had a higher accuracy.NAA/Cho equating to 1 .82 could be used as the boundary indi-cators between metabolic syndrome without deafness and with deafness groups.The areas of the other indicators un-der the ROC curve were <50%.Conclusion NAA/Cho may be the early warning marker of sensorineural deafness in patients with metabolic syndrome.

Objective To investigate the therapeutic efficacy of Yinzhi-huang combined with probiotics in the treatment of neonatal hyperbilirubinemia.Methods 80 neonates of hyperbilirubinemia were recruited into a treatment group (40 cases) and a control group (40 cases).The control group was treated with the gap blue light irradiation,besides,patients with rapid increase or high level of bilirubin were additionally treated with acid-correcting agents,Liver enzyme inducer,and albumin infusion; while the treatment group was additionally treated with Yinzhi-huang and probiotics on the basis of the control group.The values of serum total bilirubin before the treatment Was determined in both groups.During treatment,the changes of daily bilirubin,were monitored with percutaneous bilirubin monitor,and the time for serum bilirubin values decreased to normal level was studied in both groups.Results The two groups showed no significant difference in examination of the serum bilirubin values before treatment(P＞0.05).The daily bilirubin decreased value of treatment group(53.07± 17.80) μmol/L showed statistically significant compared with the control group(30.56± 13.43)μmol/L(P＜0.05); the time for serum bilirubin values decreased to normal level in the treatment group (4.87± 2.06) d was significantly different compared with the control group (7.12± 2.33) d,(P＜ 0.05).The apparent effective rate in the treatment group 75％ (30/40) was higher than that in the control group 35％(14/40)with statistical significance(x2=5.89,P＜0.05).The total effective rate in the treatment group 92.5％ (37/40)was higher than the control group 75％ (30/40)with statistical significance (x2=4.50,P＜0.05).Conclusion Yinzhi-huang combined with probiotics has better effects than conventional treatment in decreasing the daily bilirubin values,restoring normal serum bilirubin time of neonatal hyperbilirubinemia and it is worthy of clinical application.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate into neuron-like cells in new environment after transplantation, and then to replace damaged cells for reconstructing neural circuit. OBJECTIVE: To establish the co-culture system between rat BMSCs and neural cells in vitro, and to study the influence of neural cells on the differentiation of BMSCs into neuron-like cells in the co-culture system. METHODS: The neural cells obtained from Wistar rat fetal brain tissue and BMSCs gained from rat thighbone were co-cultured in Transwell culture plate. The morphological changes of BMSCs were observed and the special markers of neural cells in BMSCs were examined by immunofluorescence on the fifth day of the co-culture. The results were compared with control group which where BMSCs were alone cultured. RESULTS AND CONCLUSION: BMSCs in the neural cells co-culture system extended, were radial, connected each other. Neuron specific enolase immunoreactions showed positive results, showing neuron-like cells. The positive ratio of neuron specific enolase-positive cells was (33.0±10.5)%. However, BMSCs in the control group did not express neuron morphological character. Immunofluorescence exhibited that cells were negative for neuron specific enolase. These indicate that microenvironment provided by neurons improves the differentiation of BMSCs into neuron-like cells.

Objective:To determine the content of ferric oxide in calamine powder. Methods:Flame atomic absorption spectrom-etry ( FAAS) was used to determine the content of ferric oxide. The determination results were compared with those of the titration method. Results:There was a good linear relationship between the absorbance and the concentration of iron within the range of 0. 5-4μg·ml-1 , the relative standard deviation of the repeatability test was 1. 2%, the average recoveries were 100. 4% and 99. 4%, the limit of quantitation and detection was 0. 081 μg·ml-1 and 0. 024 μg·ml-1 , respectively. Conclusion:The method of FAAS is ac-curate and quick with good specificity and high sensitivity, which can be used for the determination of ferric oxide in calamine powder.