Programmed death1-ligand(PD-L1)is a new member of B7 family,whose receptor is pro-grammed death-1(PD-1). The interaction between PD-L1 and PD-1 can down-regulate the activation of immune response. There are some differences in the expression of PD-1 and PD-L1 in normal tissues and tumor tissues, which may provide a new way for the immunotherapy of carcinoma.

Objective To assess the efficacy and safety of recombinant human Ad-p53( rAd-p53) injection combined with cisplatin in treating malignant pleural effusion by conducting a Meta-analysis. Methods A comprehensive collection of randomized controlled studies(RCTs)of rAd-p53 combined with cisplatin versus single cisplatin in the treatment of malignant pleural effusion was retrieved form Cochrane Library,Pubmed, EMBase,CBM,CNKI,Wanfang and VIP databases. Meta-analysis was conducted by RevMan 5. 2 software. Results Ten RCTs involving 538 patients were identified in the study. The Meta-analysis results showed that rAd-p53 combined with cisplatin group had a higher hydrothorax total remission rate than single cisplatin group (RR = 1. 67,95% CI:0. 90-2. 01;Z = 5. 51,P = 0. 000 01). The PS score in rAd-p53 combined with cisplatin group was better than that in single cisplatin group(RR = 1. 76,95% CI:1. 45-2. 14;Z = 5. 69,P <0. 000 01). The incidence rate of adverse reaction of heating in the former was higher than that in the latter (RR = 3. 10,95% CI:2. 25-4. 27;Z = 6. 94,P < 0. 000 01). There were no significant differences in adverse reactions of chest pain(RR = 0. 99,95% CI:0. 50-1. 96;Z = 0. 04,P = 0. 97),gastrointestinal reaction (RR = 1. 16,95% CI:0. 90-1. 50;Z = 1. 13,P = 0. 26)and marrow suppression(RR = 1. 09,95% CI:0. 81-1. 47;Z = 0. 59,P = 0. 55)between the two groups. Conclusion rAd-p53 combined with cisplatin therapy for the treatment of malignant pleural effusion is superior to single cisplatin therapy. Mean while,fever is self-limited,and the safety is identified. It is worthy for promotion of rAd-p53 injection combined with cisplatin inclinical treatment of advanced malignant pleural effusion.

Objective To explore the levels of neutrophil gelatinase -associated lipocalin(NGAL)and Ser-um cystatin C(CysC)in plasma in essential hypertension(EH)and to discuss their clinical significance.Methods 92 patients with essential hypertension were selected as EH group.At the same time,88 healthy subjects were selected as the healthy control group.The levels of plasma NGAL,serum CysC and some other biochemical markers were detected.The results were statistically processed.Results The level of Plasma NGAL in EH group was(149.22 ± 11.52)μg/L and the level of serum CysC in EH group was(0.92 ±0.03)mmol/L.The level of Plasma NGAL in the healthy control group was(101.4 ±7.71)μg/L and the level of serum CysC in the healthy control group was(0.71 ± 0.02)mmol/L.The levels of Plasma NGAL and serum CysC were significantly increased in EH group compared with those of the healthy control group(F =27.491,P <0.01;F =24.646,P <0.01).Plasma NGAL was positively corre-lated with the degree of EH and the level of serum CysC(r =0.48,P <0.01).Conclusion Plasma NGAL and serum CysC were significantly increased in EH patients,with a significant positive correlation to the degree of nephropathy damage.Both of them can become diagnostic measurements for early diagnosis of nephropathy damage induced by EH.

Clinical oncology is becoming more and more important as the tumor incidence increases year by year. According to the need of clinical teaching, some important contents in teaching should be emphasized. And some ideas should be pard attention to such as chronic disease needing long-period and long period of treatment of chronic tumor diseases, necessary pathlolgical diagnosis, in despensible evidence-based medicine, multidisciplinary treatment combined with individualized treatment, caring psychological problems and pain in cancer patients, recognizing tumor research progresses by way of molecular targeted therapy. Finally, some teaching methods to raise study interest in a flexible way were put forward.

Objective To observe heart functions of the patient with cancer receiving combined chemotherapy of paclitaxel plus cisplatin through troponin test and speckle tracking echocardiography. Methods 43 patients who had been scheduled to receive combined chemotherapy of paclitaxel plus cisplatin were recruited in the study. Ser-um cTnT and cTnI levels were measured before chemotherapy,after the first cycle of chemotherapy,middle cycle of chemotherapy and after the last cycle of chemotherapy. In all patients, the lobal longitudinal systolic strain( GSL) and strain rate(GSRs)of the LV as well as peak early-diastolic strain rate (GSRe) and peak late-diastolic strain rate ( GSRa) were measured by two-dimensional speckle tracking echocardiography at every stage. Results The patients' serum cTnT and cTnI level after chemotherapy were increased gradually(P<0.01). After the last stage of chemotherapy the GSL and GSRs decreased significantly, having made significance in statistics ( P <0.01 ) . Compared with those before chemotherapy, the patients' GSRe and GSRa in the early stage of chemotherapy had no significant difference (P>0. 05), but compared to those of the middle and last stage of chemotherapy, significant difference (P<0.01) existed. Conclusion Paclitaxel plus cisplatin induce certain subclinical myocardial injury to patient's heart. Cardiac troponin level and speckle tracking echocardiography have important value in the obser-vation of heart functions of the patients with cancer receiving chemotherapy.

Objective To study the impact of the high temperature and muggy weather on the people’s life and work. Methods The data of summer temperature and relative humidity (Jun-Aug) from 1971 to 2000 and that of 2006 were used and the characteristic of muggy weather and distribution in main cities, Chengdu, Guangyuan, Yibing, Suining and Dazhou in Sichuan basin were compared, the influence of the thermal environment on people comfort degree was evaluated by using temperature-humidity index. Results 177 high temperature days, 17 high temperature processes, 167 muggy weather days and 12 muggy processes were seen in 5 cities in Sichuan basin in the summer of 2006. The thermal environment of Chengdu and Dazhou mainly manifested the lighter heat, heat and lower comfort degree. At 2 p.m., the relative humidity weakened the comfort degree in Chengdu, but enhanced it in Dazhou. The duration of non-comfort degree in Dazhou was longer than that in Chengdu. Conclusion The relative humidity has a strong impact on people comfort degree and the combined use of temperature and relative humidity will be useful to evaluate the city thermal environment and people comfort degree.

Objective To develop a HPLC-DAD method for the simultaneous determination of 20 synthetic pigments in dyed Traditional Chinese Medicine. Methods The samples were extracted with ultrasonic by 70% methanol, separated on a Agilent TC-C18 column ( 4. 6 mmí250 mm, 5 μm ) by gradient elution using a mobile phase made up of methanol and 0. 02 mol·L-1 ammonium acetate, and detected at 210-650 nm. The retention times and ultraviolet absorption spectrums were used to text and verify. Results The twenty red and orange synthetic pigments were separated and detected. OrangeIIsodium salt and 808 scarlet were detected in some batch of Croci stigma and Cinnabaris. Conclusion The method is simple, rapid, accurate, repeatable for determining twenty synthetic pigments in dyed Traditional Chinese Medicine.

Objective To investigate the changes of cellular immunity and humoral immunity in children with acute or critical illness. Methods Seventy-three critically ill children admitted to PICU of Chil-dren′s Hospital Affiliated to Fudan University during the period from April,2015 to September,2015 were the objects of study. Blood samples were collected within 48 hours after admition. The lymphocyte subpopulation was measured by flow cytometry,and the level of humoral immunity was measured by rate immune scatter turbidimetry,and the neutrophil function was measured by flow cytometry-DHR analysis. Twenty-three cases from 73 cases were detected the second time after admitted to hospital for seven days. Ten health children be-fore elective surgery were selected as control. Results (1) Compared with the control,the percentages of CD3 +T cells and CD8 +T cells were significantly decreased in critically ill children within 48 hours of admis-tion[(57. 43 ± 13. 46)%,(21. 26 ± 7. 87)% vs. (66. 24 ± 5. 27)%,(26. 82 ± 7. 63)%,P<0. 05]; At the same time,CD4 +T cells and NK cells had no significant change[(33. 42 ± 11. 29)%,(8. 83 ± 7. 77)% vs. (34. 89 ± 4. 94)% (11. 34 ± 5. 60)%,both P<0. 05]; While B cells were significantly increased[(31. 69 ±13. 83)% vs. (21. 08 ±7. 24)%,P<0. 05]. Neutrophil activation rate[(14. 32 ±14. 81)%] was signifi-cantly higher than the normal reference value ( 0 -10%) and the activation rate was more than 90% after stimulated by PMA. The plasma level of complement C3[(0. 88 ± 0. 31) g/L] was lower than that of the control group[(1. 19 ± 0. 18)g/L,P<0. 05]. (2) Compared with the first time,the percentages of CD3 +cells and CD4 + cells were increased after treated for one week in 23 patients[(61. 20 ± 13. 56)%,(36. 79 ± 9. 95)% vs. (56. 80 ± 13. 99)%,(32. 86 ± 10. 87)%,both P<0. 05]. No significant difference in neutrophil activation and activation rate after PMA stimulation was found compared with admition. IgA,IgM and comple-ment C3 were significantly increased[(0. 98 ± 0. 75) g/L,(1. 00 ± 0. 39) g/L,(1. 15 ± 0. 34) g/L vs. (0. 80 ± 0. 69) g/L,(0. 86 ± 0. 48) g/L,(0. 93 ± 0. 23) g/L,all P<0. 05]. Conclusion Immune disorders occur in critically ill children in the early stage of illness,the most obvious change is cellular immune response,and im-mune function starts to recover after one week.

Objective To analyse the DNA heterogeneity of 20 clinical isolates of Acinetobacteria using infrequet-restriction-site PCR (IRS-PCR ).Methods Strain-specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction of 20 strains of Acinetobacter were compared with the results of genotype with RAPD as well as the results of biotyping.Results Among the 20 bacteria, ten can be recognized as Acinetobacter haemolytius with biotyping, seven as Acinetobacter lwoffi, while the other 3 bacteria can not be recognized. Acinetobacter haemolytius isolates were divided into 5 gene types with IRS-PCR, isolates of Acinetobacter lwoffi were divided into 4 gene types, meanwhile, the last three bactria were divided into 2 gene types. With RAPD technique, Acinetobacter haemolytius, Acinetobacter lwoffi and the other 3 bacteria were divided into 6 gene types, 4 types, and 2 types by prime 1, respectively, the amplifying results of primer 2 divided Acinetobacter haemolytius into 9 gene types, the Acinetobacter lwoffi ,5 types and the other 3 bacteria,2 types. Conclusion IRS-PCR can be used for typing Acinetobacter and is more aceurate than biotyping. It has the same recogniton abili ty as RAPD while is of better stability and repeatability, so this method is capable of clinical application.

Objective To determine the clinical value of real time interventional ultrasound guidance in family planning reproduction operation.Methods Under the guidance of ultrasound monitoring,522 cases with high risk and difficult uterine operation were undertaken in our department.Results The abdominal endoscopic contraceptive uterine operation under real time ultrasound monitoring was carried out for 522 cases in 4 years,with successful rates for high risk pregnancy as 287/289 cases,high risk troublesome withdrawal of contraceptive ring as 129/130 cases and puzzling uterine operation as 103/103 cases.The total successful rate reached 99.42%,without uterine rupture and other complications.Conclusion The former complex,blind and difficult uterine operations turn to be simple,safe and reliable under the guidance of real time ultrasound.