Immunotherapy has become an important treatment for melanoma.The anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) antibody or programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor is safe and effective for melanoma patients with autoimmune disease (AD).However, when such patients are treated with anti-CTLA-4 antibody or PD-1/PD-L1 inhibitors, their condition changes should be closely monitored to prevent and avoid possible AD progression and immune-related adverse events.

Objective:To compare the antihypertensive effect of L-amloipine with that of a mlodipine.Methods:Blood pressure and heart rate of SHRs were measured with blood press ure meter of rat (SBP-1) by administrating L-amlodipine and amlopdipine through mo uth.Hemodynamic parameter of anaesthetic dogs was determined by administrating drugs through duodenum with Polygraph System (RM6000).Results:L-amlodipine could slowly reduce the blood pressure and heart rates of clearing SHRs,it could also reduce the blood pressure of normal anaesthetic dogs and the action of L-amlodipine was similar to that of amlodipine.Conclusion:L-amlodipine as a new antihypertensive drug can significantly re duce blood pressure.

Objective To recognize the characteristics and causes of the adverse drug reaction (ADR)of traditional Chinese patent medicine,and promote the clinical safe drug use.Methods By retrospective study,ADR reports about Chinese patent medicine collected by Shouguang adverse drug reaction monitoring center from January 1,2012 to December 31,2014 were analyzed statistically.Results A total of 479 reports in accordance with the inclusion criteria were collected,which comprised 479 patients.Of them,224 were male and 255 were female,often occurs in patients over 50 years old[53.0%(254 /479)].Chinese patent medicine involved in these reports were mainly blood -regulating formula,heat agent and formula for resuscitation,respectively 278 cases(58.0%),64 cases (13.4%),51 cases (10.6%).Intravenous administration was an important way to trigger ADR [78.5%(376 /479)],78.5% injection had adverse effects and suitability of medicine were 55.9%.Main clinical manifesta-tions were lesion of skin and its appendages[35.1%(183 /522)]and digestive system damage[18.4%(96 /522)]. Conclusion The application of traditional Chinese medicine syndrome differentiation as the primary principle,atten-tion to individual differences of patients,improve the level of rational use drugs,strengthen the proprietary Chinese medicine preparation process and improve the drug instructions can reduce the adverse reaction occurred to some extent of Chinese patent medicine.

Objective: To assay the content and stability of vitamin C(VC) in serum by a simple, specific method. Methods: Serum samples were extracted by metaphosphoric acid, and analyzed on a column C 18 of HPLC with DAD detector at 234 nm. Mobile phase was 100 mmol/L KH 2PO 4, pH3.00. The flow rate was 1 ml/min. Results: Under this condition, the retention time of VC was 5.76 min. The within run and between run reproducibilities tests were 0.42% and 2.11% respectively, and the recovery rate ranged from 82% to 88.5%. Stored at -70 ℃ and compared to that of its metaphosphoric acid extract, serum VC content was stable only for two days, and then decreased rapidly, whereas it did not decrease in metaphosphoric acid extract until the fifth day. Conclusion: A simple, sensitive and reliable method of HPLC with DAD detector is established for measuring VC in either serum or fruit, such as orange juice. VC should be determined immediately or should be extracted with metaphosphoric acid as soon as possible, then the extracts are kept at -70 ℃, and analysed within 5 d.

Inductive diagram material database is a branch material database to complement the multimedia courseware material database.It has a lot of advantages such as brief,explicit and emphasis characteristics,could enhance teaching efficiency and quality.This paper would discuss the advantage of application of inductive diagram in rehabilitation education.

Objective To investigate the application value of volumetric modulated arc therapy (VMAT) combined with zoledronic acid in treatment of vertebral metastases. Methods A total of 58 patients with vertebral metastasis in Qingdao Central Hospital from January 2015 to June 2017 were extracted according to simple random sampling method. The data of 58 patients were analyzed retrospectively, and they were divided into 2 groups according to the different radiotherapy technology. The study group (28 cases) received VMAT combined with zoledronic acid treatment, and the control group (30 cases) received general radiotherapy combined with zoledronic acid treatment. The efficacy and tissue damage of the patients in both groups were compared according to the evaluation criterion including the local control rate, pain relief rate, local progression-free survival rate and exposure of the spinal cord. Results The local control rates were 92.9 ％ (26/28) and 73.3 ％ (22/30) respectively in the study group and the control group (χ2= 3.869, P=0.049). The pain relief rates were 96.4 ％ (27/28) and 76.7 ％ (23/30) respectively (χ2= 4.757, P= 0.029). The local progression-free survival rates of 3-month were 85.7 ％ (24/28), 60.0 ％ (18/30) respectively (χ2=4.794, P= 0.029) and the local progression-free survival rates of 6-month were 78.6 ％ (22/28), 50.0 ％(15/30) in the study group and the control group (χ2=5.119, P=0.024). The exposure of the spinal cord was (29.80±0.88) Gy and (39.90±0.20) Gy, respectively (t= -61.083, P= 0.000). Conclusion VMAT combined with zoledronic acid can improve the local control rate, pain relief rate, local progression-free survival rate, and reduce the exposure of the spinal cord.

Micronutrients are important factors affecting the immune system. Micronutrients contribute to maintaining the normal functions of immune system through maintaining the integrity of skin and mucosa, regulating the activity of cytokines, and mediating the proliferation and differentiation of T cells and B cells. Human immune system changes at different stages of growth and development, and micronutrient deficiency can impair the immune system and increase the susceptibility to respiratory infections. Therefore, maintaining the optimal nutritional status is beneficial for the immune system to prevent respiratory infections. Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection is one of the respiratory infectious diseases that is of most concern recently. Micronutrient supplementation has been shown to have positive effects on the prevention of, symptom relief of and recovery from SARS-Cov-2 infection. Further studies are needed to systematically evaluate the effects of micronutrients on immunity and respiratory infections, and to identify the appropriate timing and dosage.

OBJECTIVETo evaluate the effectiveness of small interfering RNA (siRNA) on inhibiting severe acute respiratory syndrome (SARS)-associated coronavirus replication, and to lay bases for the future clinical application of siRNA for the treatment of viral infectious diseases.

METHODSVero-E6 cells was transfected with siRNA before SARS virus infection, and the effectiveness of siRNA interference was evaluated by observing the cytopathic effect (CPE) on Vero-E6 cells.

RESULTSFive pairs of siRNA showed ability to reduce CPE dose dependently, and two of them had the best effect.

CONCLUSIONsiRNA may be effective in inhibiting SARS-associated coronavirus replication.

Animals ; Cercopithecus aethiops ; RNA, Small Interfering ; pharmacology ; SARS Virus ; drug effects ; Transfection ; Vero Cells ; Virus Replication ; drug effects

Objective: To conduct a comprehensive and systematic review of the efficacy and safety of Wenxin Keli (WXKL) in the treatment of atrial fibrillation (AF) . Methods: Seven databases (PubMed, The Cochrane Library, Web ofScience, CNKI, Wanfang Database, VIP and SinoMed) were searched to identify relevant randomized controlled trials (RCTs) from inceptions to 1 October, 2018. Two review authors independently assessed the methodological quality andanalyzed data by Cochrane handbook and the Rev Man 5.3 software. Begg.s test was conducted to assess publication biasvia Stata 14 software. Results: Twenty-four RCTs with 2246 patients were included in this review. Compared with blankcontrol, placebo or western medicine alone, WXKL alone or combined with western medicine could effectively reducerapid ventricular rate (MD=-7.14, 95％CI:-8.42——5.87), the frequency and duration of AF. It could also shorten thesinus rhythm conversion time (MD=-3.04, 95％CI:-3.47——2.61), increase the sinus rhythm conversion rate (RR=1.19, 95％ CI: 1.09～1.29) and decrease recurrence rate of AF (RR=0.28, 95％ CI: 0.13-0.59) . Besides, WXKL alone orcombined with western medicine was beneficial for improving the left ventricular ejection fraction (LVEF) (MD=3.44, 95％ CI: 0.87-6.01), left ventricular end diastolic diameter (LVEDD) (MD=-2.47, 95％ CI:-2.86——2.08), left atrialdiameter (LAd) (MD=-0.91, 95％CI:-1.58——0.25) and P wave dispersion (Pd) (MD=-4.04, 95％CI:-4.15——3.93) .WXKL combined with low-dose amiodarone was superior to conventional-dose amiodarone alone in improving themaximum P wave (Pmax) (MD=-8.25, 95％ CI:-10.33——6.17), and WXKL combined with conventional-doseamiodarone is more effective (MD=-13.10, 95％CI:-13.65——12.55) . Compared with the control group, the treatmentgroup had fewer adverse reactions, and the Begg.s test did not find any publication bias. Conclusion: WXKL alone orcombined with western medicine exhibited better therapeutic effects in the treatment of AF, but these results still needhigh-quality evidence to verify.

Objective: To investigate the effect of compound sophora flavescens injection on T helper cells 17 (Th17), regulatory T-cells (Treg cells) and the related cytokines in lung cancer patients with cirrhosis. Methods: A total of 63 patients with early non-small cell lung cancer and cirrhosis in Shouguang People's Hospital of Shandong Province from January 2016 to January 2018 were selected. All patients were scheduled to undergo surgical treatment. The patients were randomly divided into observation group (33 cases) and control group (30 cases) according to the random number table method. The patients in the control group were treated with liver protection, and the patients in the observation group were given compound sophora flavescens on the basis of the control group. After 3 months of treatment, the changes of liver fibrosis index, the levels of Th17 and Treg cells in peripheral blood and the changes of interleukin (IL)-10, IL-17, IL-6, and transforming growth factor (TGF)-β in serum were compared between the two groups. Results: After treatment, the alanine aminotransferase (ALT) of 15 cases (45.45%) in the observation group were normalized and 6 cases (20.00%) in the control group were normalized. There was a significant difference in ALT normalization rate between the two groups (P < 0.05). The levels of serum laminin (LN) and hyaluronic acid (HA) in the two groups after treatment were lower than those before treatment (all P < 0.05), and the serum LN [(156.74±30.52) ng/ml] and HA [(179.56±25.32) ng/ml] in the observation group after treatment was lower than those in the control group [(210.58±39.42) ng/ml and (203.75±28.79) ng/ml] (t values were 18.236 and 12.184, both P < 0.01). There was no significant difference in the level changes of type Ⅲ procollagen and type Ⅳ collagen between the two groups before and after treatment (all P > 0.05). After treatment, the levels of Th17 and Th17/Treg increased and the level of Treg cells decreased (all P < 0.05). After treatment, the levels of Th17 [(1.32±0.18)%] and Th17/Treg (0.23±0.04) in the observation group were higher than those in the control group [(1.21±0.17)% and 0.20±0.03] (t values were 3.201 and 1.087, both P < 0.01), while the level of Treg cells in the observation group was lower than that in the control group (P < 0.05). After treatment, the serum levels of IL-10, IL-17, IL-6, and TGF-β in the two groups were lower than those before treatment (all P < 0.05), and their levels in the observation group were lower than those in the control group (all P < 0.05). Conclusion Compound sophora flavescens injection can improve the liver function and fibrosis index of patients with lung cancer and cirrhosis, and it can regulate the levels of Th17, Treg cells and their related factors, which can be used as a clinical adjuvant.