Programmed death-1(PD-1)is a major co-suppression receptor expressed on T cells.Binding with its ligands (PD-L1 and PD-L2),PD-1 can inhibit T cell proliferation,activation and cytokine secretion.In normal organs,PD-1 /PD-Ls signaling pathway plays an important role in maintaining immune tolerance,while during tumorigenesis,it can suppress T cell immune response and promote tumor immune escape.This article reviewed the research progress on PD-1 /PD-Ls signaling pathway,comprised of structure and expression of PD-1 /PD-Ls, mechanism of the signaling pathway,as well as the expression characteristics of soluble form of PD-1 /PD-L1 (sPD-1 /sPD-L1),and summarized the categories of anti-PD-1 /PD-Ls antibodies and their clinical trials in canc-er immunotherapy.

Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.

Objective To understand the schistosomiasis control progress and endemic situation,so as to provide the evi?dence for formulating the strategy of schistosomiasis elimination in Sichuan Province. Methods The schistosomiasis history da?ta,working reports of schistosomiasis prevention and control,schistosomiasis surveillance data,and data of schistosomiasis pre?vention and control capacity were collected and analyzed for the schistosomiasis control progress and epidemic situation in Sich?uan Province from 2004 to 2015. Results There were 63 schistosomiasis endemic districts in 11 cities in Sichuan Province, and the standard of schistosomiasis transmission interruption was achieved in the whole province in 2015. Currently,the area with Oncomelania hupensis snails was 2 537.54 hm2,and there were 1 769 advanced schistosomiasis patients. From 2004 to 2015,the accumulated survey area with snails was 433 065.80 hm2,and the area of snail control by molluscicides was 251 259 hm2. There were 26.017 144 million person?times of schistosomiasis blood tests and 7.89 million person?times of chemotherapy. There were 1.276 117 million head?times of cattle that received the schistosomiasis examinations. The schistosomiasis patients and livestock and the area with snails were decreased year by year. Since 2010,there were no local schistosome?infected resi?dents and livestock and since 2004,there were no schistosome?infected snails. However,in some area,the professional person?nel were less,the technology and hardware lagged behind,and the schistosomiasis prevention and control capacity was weak. Conclusions Sichuan Province achieved the standard of schistosomiasis transmission interruption in 2015. In the future,the comprehensive schistosomiasis prevention and control strategy still should be strengthened,including the promotion of schistoso?miasis prevention and control capacity,establishment of sensitive early?warning surveillance system,and implementation of ac?curate schistosomiasis prevention and control,in order to consolidate the control achievements and realize the aim of schistoso?miasis elimination as soon as possible.

OBJECTIVE:To analyze the safety of linezolid (LZD) for elderly patients,and probe into the regularity of adverse reaction (ADR).METHODS:In retrospective study,elderly patients treated with LZD injection or tablets were selected from our hospital during Jan.2014-Dec.2015.The occurrence of ADRs were analyzed statistically.RESULTS:A total of 126 patients were included,the age was from 65 to 94 year-old,and the mean duration of treatment was (9.47 ± 6.31) d (ranged 1-35 d).Forty-five cases suffered from ADR after medication (35.71％),followed by 39 cases of thrombocytopenia (30.95％),9 cases of leukocytopenia(7.14 ％),7 cases of hemoglobin reduction (5.55 ％),6 cases of nausea and vomiting (4.76 ％),4 cases of transaminase elevation (3.17％),4 cases of diarrhea (3.17％),2 cases of lactic acidosis (1.59％),2 cases of skin rash (1.59％) and 1 case of drug fever (0.79％).The incidence of thrombocytopenia in ICU patients was significantly higher than non-ICU patients,with statistical significance (P=0.019).There was no significant difference among different dosage forms of LZD without statistical significance (P=0.218).CONCLUSIONS:Clinicians and pharmacists should closely monitor the application of LZD in elderly patients,pay more attention to ADR induced by LZD,especially in ICU,it induces the high incidence of thrombocytopenia.Meanwhile,it is suggested to monitor serum lactate concentrations regularly during treatment.

Objective To investigate the correlation between plasma homocysteine (Hcy) level and cerebral microbleeds (CMBs) band leukoaraiosis (LA) in patients with acute stroke.Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively.The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI.Fasting venous samples were obtained and the plasma Hey concentration was measured the next day after admission.Results A total of 139 patients with acute stroke were enrolled,67 of them were females and 72 were males (mean age 70.1 ± 10.2 years); 24 had hemorrhagic stroke and 115 had ischemic stroke.The age (76.23 ± 8.74 years vs.64.58 ± 7.42 years;t =4.621,P =0.012) hypertension ratio (89.13％ vs.67.74％ ;x2 =8.324,P =0.0 370) and plasma Hey level (14.53 ± 4.31 mmol/L vs.11.31 ±3.16 mmol/L;t =6.538,P=0.008| in a severe LA group (n=46) were significantly higher than those in a non-severe LA group (n =93).Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA (rs =0.365,P =0.002).Multivariate logistic regression analysis showed that the increased Hey level (odds ratio [ OR ],1.366,95％confidence interval [ CI] 1.141 - 1.526; P =0.010) and age (OR 1.093,95％ CI 1.031 - 1.162; P =0.016)were the independent risk factors for severe LA.The age (74.37 ± 6.35 years vs.67.56 ± 8.52 years; t =6.628,P =0.038) and hypertension ratio (94.74％ vs.62.20％;x2 =8.773,P =0.002) in a CBM group were significantly higher than those in a non-CMB group (n =82).Spearman correlation analysis showed that there was no significant correlation between the plasma Hcy level and the numbers of CBMs (rs =0.038,P =0.813).Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs.Conclusions The elevated plasma Hcy level was associated with LA,but it was not associated with CBMs.

Objective To understand the changes of schistosomiasis endemic situation in Sichuan Province,the upstream of Yangtze River basin,and the impact on schistosomiasis transmission in Three Gorges Reservoir area after the construction of Three Gorges Reservoir. Methods The annual reports of the schistosomiasis endemic situation in Sichuan Province from 2000-2012,the data of the schistosomiasis surveillance sites in Sichuan Province from 2001-2012,the data of the schistosomiasis sampling survey in Sichuan Province in 2001,and the relevant reference of Three Gorges Reservoir were collected. The schisto-somiasis prevalence in human and cattle,and Oncomelania hupensis snail status were investigated. The snail survey was imple-mented in Qianjin Village,Jianyang City,Sichuan Province,the nearest village to Three Gorges Reservoir Area. Results The schistosomiasis endemic situation presented a continuous declining state in Sichuan Province from 2000-2012,and reached the criteria of schistosomiasis transmission controlled in 2008. From 2012,65.07%of endemic counties reached the criteria of schis-tosomiasis transmission interrupted. From 2006,no schistosome infected snails were found. In Qianjin Village,1714 m2 environ-ments were surveyed and no snails were found. Conclusions The schistosomiasis endemic area and snail area are significantly reduced in Sichuan Province,the upstream of Yangtze River basin,after the construction of Three Gorges Reservoir. Therefore, the possibility of schistosomiasis endemic diffusing to Three Gorges Reservoir area is minimum.

Objective To establish an index system of the key factors of elimination of schistosomiasis. Methods A ques?tionnaire was designed based on the reference review,and 24 scientists working in the field of schistosomiasis control or re?search or management were investigated by using the Delphi method. The importance of each index reflecting the endemicity of schistosomiasis was scored by each scientist. The assessing system for key factors of eliminating schistosomiasis was established , and the normalized weight and combined weight were calculated. Results The assessing system included three indexes in the first grade,seven indexes in the second grade and thirteen indexes in the third grade. Among the indexes in the first grade,the normalized weights of endemicity,natural environment and social environment were 0.371 1,0.339 5,and 0.289 4,respective?ly. Among the indexes in the second grade,the economy showed the highest combined weight of 0.289 4 while the agriculture and sanitation both showed the lowest score of 0.112 7. Among the indexes in the third grade,the infection rate of animals showed the highest combined weight of 0.124 6 while the agriculture and plant structure both showed the lowest score of 0.053 0. Conclusion The indexes of the assessing system provide the scientific evidence for surveillance work when elimination of schis?tosomiasis.

Objective From the perspective of making full use of database comparison function, giving certain guidelines to analyze mixed DNA profile,compare database,screen comparison results. Methods Using CPI to describe the identification of mixed DNA profile.Using CPBI to estimate reliability of individual samples being included. Results When CPI is less than 10-7, mixed DNA Profile is worth to be compared in database.When the number of alleles at one locus is more than 2, retain an additional allele will not reduce identification too much. According to the CPBI of the included samples,we can find the most reliable sample.

Objective To explore the application effects of the clinical nursing muscle strength assessment record for patients with spinal cord injury based on the color separation Symbol Marking Method. Methods According to the neural classification standard of spinal cord injury formulated by the American Spinal Cord Injury Association, the main 10 groups of key muscles innervated by the motor function of spinal cord were sequentially set from top to bottom and from left to right. Different colors were used to distinguish the base plates of left and right limbs, and a special muscle strength evaluation record sheet was designed and made for patients with spinal cord injury. A total of 40 nurses for the Spinal Surgery Department of He'nan People's Hospital were recruited as the research subjects, and divided into study group and control group with 20 cases in each. 60 patients with spinal cord injury who were admitted to the spinal ward from June 2016 to December 2016 in this department were selected as the objects of assessment. The self-made muscle strength assessment record was applied in the study group, while the conventional writing method were applied in the control group. The rate of error evaluation, the rate of missing evaluation, the time of evaluation record were compared between the two groups,evaluate the satisfaction of study group nurses. Results In the study group, the rate of missing evaluation was lower than that in the control group (P＜ 0.05), and the time of recording in the observation group was shorter than that in the control group (P＜0.05), but there was no significant difference between the two groups on error evaluation (P ＞ 0.05). 95% of nursing staff in the study group were willing to use muscular strength assessment record, with a high satisfaction. Conclusions Muscle strength assessment records based on the color separation area symbol method can reduce the error rate, save the recording time, and improve the satisfaction of nurses. It also standardizes the working process and recording standards of nurses.

MicroRNA (miRNA or miR) is a class of highly conserved endogenous non-coding RNA of 21~25nt, which is widely existed in organisms. Currently, miRNA has been proven to be associated with cardiovascular diseases in clinical research, but it has not been reported in the field of forensic medicine. This paper highlights recent findings about miRNA and its application in cardiovascular diseases, and the application aspect of miRNA in sudden cardiac death in forensic science.