The latest study shows that the expression abnormalities of programmed death 1/programmed death ligand 1 (PD-1/PD-L1) signaling pathway in a variety of solid tumor tissues and cells are related to disease progression and poor prognosis, and directly involve in tumor immune escape, becoming the recent focus. With the further research, PD-1/PD-L1 signaling pathway in blood diseases, for example, in the development of lymphoma, is catching more attention gradually. The signaling pathway not only is associated significantly with malignancy, progression, recurrence of lymphoma and prognosis of patients, but probably becomes a new target for cancer immunotherapy. This paper summarizes the expression and research status of the biological characteristics and mechanism of PD-1/PD-L1 signaling pathway in lymphoma, in order to provide a new way for lymphoma treatment.

The P2X7 receptor (P2X7 R)is a nonselective cation channel activated by extracellular ATP,and it may trigger the se-cretion of several proinflammatory substances,such as IL-1β, IL-18,TNF-α,and nitric oxide.Several preclinical studies have demonstrated that this receptor participates in inflammation and pain mechanisms,and compounds that modulate the function of this receptor show potential as new anti-inflammatory medicines. Therefore,P2X7 receptors play particularly important physiologi-cal roles and have potential clinical application in inflammation and pain,which proves it a therapeutic target for pain manage-ment.

Aim To investigate the protective effect of different concentrations of isoflurane preconditioning in isolated rat hearts and the relationship between this effect with changes of endogenous antioxidant enzymes.Methods The isolated SD rat hearts perfused on Langendorff apparatus were randomly divided into 6 groups(n=14):control group(CON);1.44 MAC isoflurane control group(ISO);ischemia-reperfusion group(I/R);3 isoflurane preconditioning groups(I1,I2,I3).All hearts were made globally ischemic for 30 min followed by 60 min reperfusion except CON and ISO.The hearts of ISO and I1,I2,I3 were perfused with K-H solution saturated with 0.72 MAC or 1.08 MAC or 1.44 MAC isoflurane respectively for 20 min followed by 5 min washout after equilibrium.The cardiac function variables were measured after equilibrium,immediately before ischemia,at the end of 30 min and 60 min reperfusion.The infarct size and activities of the endogenous antioxidant enzymes were measured at the end of reperfusion.And the activities of enzymes in I2 group were measured after equilibrium,immediately before ischemia,immediately after ischemia and at the end of 30 min reperfusion.Results Ischemia/reperfusion significantly increased LVEDP and decreased LVDP,dp/dtmax,dp/dtmin and HR(P

Objective To investigate the values of diffusion tensor MR imaging(DTI)and fiber tractography(FT)in the assessment of cognitive functions in children with periventricular leukomalacia (PVL),to facilitate to understand the mechanism of PVL children's cognitive functions.Methods Forty six children with PVL and 16 age-matched volunters were recruited.Developmental quotient(DQ)of all cases was recorded.According to the DQ scores,patients were divided into 3 groups:mild in 11 patients,moderate in 19,and severe in 16.DTI was performed in all cases and fractional anisotropy(FA)values were be calculated.Non-paired t test was used to compare the FA values of major white matter fibers between patients group and controls group.One-way ANOVA was used to compare the FA values among 4 groups.Results Compared with controls,all 46 patients with PVL showed a significant mean FA reduction in left corticospinal tract(CST)(0.476 ±0.064 vs.0.531 ±0.064),bilateral anterior limb of internal capsula (ICAL)(left 0.357 ±0.050 vs.0.405 ±0.081,right 0.370 ±0.040 vs.0.405 ±0.036),posterior limb of internal capsule(ICPL)(left 0.483 ±0.044 vs.0.546 ±0.091,right 0.485 ±0.046 vs.0.547 ±0.083),arcuate fasciculus(AF)(left 0.367 ± 0.069 vs.0.433 ± 0.097,right 0.363 ± 0.064 vs.0.421 ±0.091),posterior thalamic radiation(PTR)(left 0.390 ± 0.059 vs.0.459 ± 0.067,right 0.382 ± 0.047 vs.0.446 ± 0.064),anterior CG(ACG)(left 0.362 ± 0.056 vs.0.423 ± 0.057,right 0.345 ± 0.056 vs.0.417 ± 0.080),superior longitudinal fasciculus(SLF)(left 0.323 ± 0.050 vs.0.426 ±0.102,right 0.341 ± 0.056 vs.0.416 ± 0.092)and splenium of the corpus callosum(SCC)(0.535 ±0.090 vs.0.606 ±0.060)(t =2.037-3.745,P ＜0.05).The severity of cognitive impairment companied with decrease of the FA values of all fibers.The FA values of bilateral CST,ICAL,ICPL,left AF,bilateral PTR,ACG,SLF and SCC were significantly different among different groups(F =3.021-7.146,P ＜ 0.05).Conclusions The damage widespread of white matter bundles is found in children with PVL DTI and FT can provide details in the assessment of cognitive impairment in children with PVL.

Objective struclured clinical examination (OSCE) is a kind of examination which could objectively evaluate the students′clinical skills.Nowadays,OSCE are wildly applied in medical educational field throughout the world.Timely discussion and analysis on the problems existed in the implementation process of OSCE is necessary.Measures should be taken to improve the OSCE examination and to meet the requirements of higher clinical practice training level such as increasing clinical skill simulation training hardware investment,optimizing settings and conlents of the examination and the test stations as well as introducing standardized patients (SP) and other measures.

Objective To investigate the characteristics of attention networks impairment in patients with lesion in the cerebellum.Methods The attention network test was used to compare patients with lesion in the cerebellum(n=28)with normal controls(n=3.1)on the efficiency of three anatomically defined attention networks:alerting,orienting,and executive control. Results The orienting network effect was significantlyworse(Z=-2.309,P＜0.05)in patients with lesion in the cerebellum((36.32±30.58) ms)than in normal controls((54.39±22.17)ms).The executive control network in patients((160.05± 83.25)ms)with lesion in the cerebellinn was worse than those of controls((93.42±37.41)ms,Z= -3.500,P＜0.01).The alerting networks effects was higher in patients((35.14±45.59)ms)than in normal controls((28.81±26.09)ms),without significant difference.The average reaction time was longer in patients than in normal controls,but there was no significant difference.The wrong rate of attention network testwas significantly higher(Z=-2.119,P＜0.05)in patients(6.57%±9.84%)than in normal controls(3.38%±5.42%).Conclusion The patients with lesion in the cerebellum may be selectively impaired of the orienting and executive networks,while the alering network is spared.

Objective:The stimulate angiogenes effect and mechanism of Shexiangbaoxin Pills on coronary collateral development in the hearts of experimental myocardial infarction rats were studied. Methods:24 myocardial infarction rats were randomly divided into 3 groups, 8 rats in group A were treated with Shexiangbaoxin Pills, 8 rats in group B were treated with Beifuji and heparin, and 8 rats in group C were treated with 0.9% normal saline as control. Infarct area, the contents of VEGF、bFGF and VⅢ factor, and vascular density in the edge of infarct section were measured after 6 weeks treating.Results: Infarct area in group A was obviously less than that in group C, the contents of VEGF、bFGF and VⅢ factor in the edge of infarct section and vascular density in group were significantly increased compared with those in group C. Conclusions: Shexiangbaoxin Pills could stimulate angiogenesis of the collateral branch of coronary artery in ischemic myocardium of rats and showed good protective on myocardial ischemia.

Objective To determine attention networks impairmnet in patients with localized brain injury and to examine the characteristics of the impairment.Methods The attention network test was used to compare patients(n=59)with controls(n=53)on the efficiency of 3 anatomically defined attention networks:alerting,orienting,and executive control.Results Firstly,patients with frontal lobe injury showed a significant deficit in the executive network(frontal lobe injury,controls:(143.7±46.6),(91.6±46.4)ms,Z=-4.714,P＜0.01)and also a significant deficit in the orienting network(frontal lobe injury,controls:(71.2±35.2),(55.1±21.8)ms,Z=-2.125,P＜0.05).There was no deficit in the alerting network(Z=-0.901,P＞0.05).Secondly,the orienting network effect was significantly lower in patients with parietal lobe injury((34.9±25.2)ms)than in normal controls((55.1±21.8)ms.Z=-2.418.P＜0.05).However,there were no significant difierences between the other two networks and between the patients and the controls(Z=-1.873,-0.186.P＞0.05).Thirdly,patients with temporal lobe injury showed no deficit in the three networks(Z=-0.037,-1.224,-0.718,all P＞0.05)as well as in overall RT and accuracy(Z=-1.385,-0.699,all P＞0.05).Conclusions These results suggest that there are selective impairments of the orienting and executive networks in patients with the frontal lobe and the parietal lobe injury,while the alerting network is spared.Furthermore,the frontallobe plays a key role in the executive control.meanwhile,the orienting network is closely related with the parietal lobe.

Objective To explore the manifestation of pancreatic metastases (PM)using contrast‐enhanced ultrasound (CEUS). Methods Eleven patients with PM confirmed by pathology or CT/MRI combined with clinical data were analyzed retrospectively. The manifestation on conventional ultrasound and the enhancement appearance on CEUS were analyzed. Results The primary malignant tumors included lung cancer(n=6), breast cancer(n=1), renal clear cell carcinoma(n=1), gastric cancer(n=1), rectal cancer(n=1)and leiomyosarcoma of uterus(n=1). Eight patients had one lesion and three were multiple. The maximum lesion diameter was 2. 0-5. 0cm. Eight of the 11 patients showed hypoechoic on conventional US. Three patients were diagnosed as probably PM, one probably malignant and 7 undetermined by US. In the early stage of CEUS, two patients showed hyper‐enhancement, six showed iso‐enhancement and 3 showed hypo‐enhancement I.n the late stage of CEUS, nine patients (9/11) showed hypo‐enhancement. Seven patients showed homogeneous enhancement S.ix patients were diagnosed as PM, three malignant, one neuroendocrine tumor and one undetermined by CEUS. Conclusions PM showed certain characteristics on CEUS. The hyper‐or iso‐enhancement at the early stage of CEUS and history of primary cancer is helpful for diagnosis of PM.

Objective To summarize the manifestation of solid pseudopapillary tumor of the pancreas (SPTP) on ultrasound and contrast-enhanced ultrasound (CEUS) and to investigate the diagnostic value of CEUS. Methods The ultrasound and CEUS images of six patients with SPTP confirmed by pathology were reviewed. According to CEUS record,the enhanced and wash-out time,enhanced speed and degree of tumor were analyzed. Results On ultrasound, SPTP presented as solid, well-circumscribed masses, usually heterogeneous in echo texture, and some of them contained macro-calcification. On CEUS, the tumor enhanced simultaneously or slightly late compared with normal pancreatic tissues. The contrast agent washed out quickly in all tumors than in normal pancreatic tissues. The enhanced degrees were equal to or less than that of the normal pancreatic tissues. Some tumors showed capsule and septum enhancement. Conclusions The manifestation of SPTP on CEUS had some features and may be helpful for differentiation diagnosis combine with ultrasound.