If loosely defined,an abscopal effect occurs when localized irradiation affects the whole organism.In recent years,distant tumor regression and normal tissue damage after localized irradiation have been concerned by immuno-oncologists.However,the mechanisms of this effect are still far from clear.Mounting evidences suggest that the generation of abscopal effects is closely related to immune regulation.Radiotherapy might become a systemic tumor-treatment modality by enhancing immune function and played an important role in every stage of tumor development and prognosis.For the moment,targeting the immune checkpoint has become an attractive approach for malignant tumor therapy.Preclinical data have revealed that a strong abscopal effect could be effectively induced by the co-treatement of immune checkpoint inhibitors and irradiation,which could recruit antitumor T cells and achieve a powerful antitumor effect.This review discusses current progress and perspectives of abscopal effects in the combination of radiotherapy and immunotherapy.

Objective:To explore the diagnostic value of treadmill exercise test (TET)and its Duke score in menopa-usal female patients with coronary heart disease (CHD).Methods:A total of 102 menopausal female patients re-ceived TET and coronary angiography (CAG)examination.With CAG as control,accuracy indexes etc.of TET combined Duke score diagnosing coronary artery disease in these patients were compared and analyzed.Results:Compared with single application of TET or Duke score,there were significant rise in specificity (27.12% vs. 30.50% vs.44.44%),positive predictive value (47.56% vs.46.75% vs.54.55%),negative predictive value (80%vs.72% vs.90.91%)and accuracy (53.92% vs.52.94% vs.64.94%)diagnosing CHD by TET combined Duke score both positive and negative,P <0.05 all;but there was no significant difference in sensitivity,P >0.05 both. There was no significant difference in CHD diagnosis between single use of TET and Duke score,P >0.05 all.Con-clusion:False positive rate of treadmill exercise test is higher in menopausal women.Treadmill exercise test com-bined Duke score is helpful to improve specificity,positive predictive value,negative predictive value and accuracy of the test.

Biomedical Research ; Drug Resistance, Neoplasm ; genetics ; Gene Expression Regulation, Neoplastic ; Humans ; Neoplasm Metastasis ; genetics ; RNA, Long Noncoding

Objective To evaluate the clinical application of COBIO XS automated urine sediment analyzer for screening urinary tract infection(UTI) .Methods Midstream urine samples were collected from 182 patients with suspected UTI .White blood cell counts(WBC) and bacteria counts(BACT) were determined by COBIO XS automated urine sediment analyzer .By comparing with quantitative urine culture as the golden standard of UTI .The area under the ROC curve(AUC) was constructed to evaluate the dis‐criminative power of variables to predict UTI .Results The positive rate of urine culture was 30 .8% .The isolated rate of Esche‐richia coli ,Enterococcus species and proteus species were 53 .6% ,16 .1% ,10 .7% ,respectively .ROC curve analysis showed that AUC was 0 .808(95% CI 0 .710-0 .867) for WBC and 0 .899(95% CI 0 .797 -0 .923) for BACT .The best cutoff value for WBC was 50/μL ,sensitivity was 89 .0% ,specificity was 83 .8% ,positive predictive value was 86 .3% and negative predictive value was 93 .7% .The best cutoff value for BACT was 110/μL ,sensitivity was 82 .5% ,specificity was 85 .6% ,positive predictive value was 78 .5% and negative predictive value was 88 .0% .Conclusion COBIO XS analyzer is adopted to conduct rapid and reliable a screen‐ing tool for UTI .

Object To establish a proper research evaluation system for level-two general hospital.Method By using Delphi method,experts were invited by letter to review research evaluation indices for three times.Result Totally 62 indices were weighted and evaluated,including two primary-degree indices,14 secondary-degree indices,and 46 third-degree indices. A research evaluation system was preliminarily established in a level-two general hospital.Conclusion The evaluation system is simple and practicable,and can reflect the main aspects of research in the leveltwo general hospitals.

Objective Analysis of the operational efficiency trends of and problems with the public tertiary hospitals. Methods A retrospective statistics analyzed the indicators of ten public tertiary general hospitals in Shanghai during 1997-2006. Results The outpatients number per capita for the hospital staff maintains an rising trend, averaging 12.2% per year prior to year 2000; The yearly-averaged total assets turnover of the hospitals decreases from 0.89 in 1997 to 0.69 in 2003, then maintaining unchanged; The yearly-averaged receivables turnover began to fall since 1999, falling from 21.4 in 1999 to 9.7 in 2006; hospital income growth fluctuated during the years, yet with a high level of total assets growth; given the fluctuations in asset-liability ratio, such ratio has been growing slowly, maintaining at 20 % since 2004. Conclusion Problems are found with the operational efficiency of these public tertiary general hospitals as follows: the rapid growth of productivity in such hospitals finds no concurrent improvements in assets related indicators. Against a low income ratio, high debt ratio will plague hospital development to some extent.

Objective To observe the effect of hyperthyroidism decoction on thyroid hormone and thyroid pathological changes of ex-perimental hyperthyroid rats. Methods 40 rats were randomly divided into four groups: Normal group,hyperthyreosis model group, western drugs control group and hyperthyroidism decoction group. The model rats were constructed by drenching Youjiale. Hyperthyroidism decoction group were given hyperthyroidism decoction of respective dosage, western drugs control group were given propylthiouracil. The serum contents of T3, T4, FT3, FT4 and TSH were determined by radio-immunity method, the thyroid pathological changes effected by hyperthyroidism de-coction were observed. Results Compared with model group, the contents of serum T3, T4, FT3, FT4, of hyperthyroidism decoction group were decreased, while the contents of serum TSH were increased. Hyperthyroidism decoction may improve thyroid pathological changes of ex-perimental hyperthyroid rats. Conclusion Hyperthyroidism decoction can effectively improve the thyroid function of experimental hyperthy-roid rats.

Objective To evaluate the effect of gamma irradiation on the proliferation,differentiation,and mineralization of murine osteoblastic cells,and to investigate the related molecular mechanism.Methods Osteoblastic cells were irradiated by different doses (0,0.5,1.0,2.0,5.0 Gy)of 137Cs γ-rays.Cell morphology was observed with a microscopy,cell viability was analyzed by MTT assay,and ALP activity was analyzed by the methods of enzyme histochemistry and PNPP.Meanwhile,gene expressions of ALP,osteocalcin (OC),collagen Ⅰ,osteoprotegerin (OPG) and receptor activator of nuclear factor-kB ligand (RANKL) were measured by semi-quantified RT-PCR.Results Cell viability decreased with the radiation doses over 1.0 Gy ( t =6.197 - 18.677,P ＜ 0.05 ).After radiation with a dose over 2.0 Gy,the cell number and the junctions of cell protrusions decreased,the cells had low refractivity and the activity and mineralization ability of ALP were also inhibited ( t =2.790 -2l.374,P ＜0.05).In addition,the expressions of ALP and OC mRNA were down-regulated significantly (t =3.563 -16.508,P ＜ 0.05) when the radiation dose was higher than 0.5 Gy,and the expressions of OPG,OPG/RANKL mRNA were down-regulated ( t =12.942,4.954,P ＜ 0.05 ) at 5 Gy.But the expressions of collagen Ⅰ and RANKL mRNA were not affected by irradiation.Conclusions The osteoblastic cells were significantly influenced by γ-irradiation,including morphological changes,inhibition of cell proliferation,differentiation and mineralization ability. Meanwhile,mRNA expressions of ALP and OC were downregulated.OPG/RANKL may be a main pathway of osteoblastic cell damage under high dose radiation.

This paper systematicly reviewed the classification and function of evaluation system for hospital scientific research based on the current and past status in domestic and internation. Differenct approches to scientific research were discussed for the purpose to further improve hospital evaluation system and to establish an appropriate system for the hospital development.

Objective To study the causes of mis diagnosis and the experience of diagnosis and management for cholelithiasis complicated with abdominal tumors.Methods Clinical data of 36 cases of cholelithiasis complicated with abdominal tumors were analyzed retrospectively.Among them,24 were male,12 female.The age ranged from 48 to 82 year old.Each case was diagnosis as cholelithiasis and admitted to our hospital.Results In 36 patients,18 was diagnosed as complecated with abdominal tumors preoperatively;12 was diagnosed intraoperatively,while in 6 cases the tumor was misdiagmosed for 5 days to 3 months,finally the tumor was comfirmed by reoperation and pathology.Among the 36 cases,the tumors cluding 5 of carcinoma of gallbladder(13.9%),4 of cholangiocarcinoma(11.1%),3 of hepatoma(8.3%),6 of pancreatic carcinoma(16.7%),6 of gastric carcinoma(16.7%),7 of colon carcinoma(19.4%),2 of rectal carcinoma(5.5%).Of them,2 cases refused operation,2 cases underwent intervention operation,the others reseived operation.During primary operation,radical resection of the tumor and cholecystectomy and/or common bile duct(CBD) exploration was performed in 18 patients,palliation resection and cholecystectomy and/or CBD exploration performed in 4 patients,exploratory laparotomy performed in 4 patients,and only LC and/or CBD exploration performed in 6 patients.Of the latters,reoperation was performed 5 days to 3 months after primary operation.4 patients had tumor radical resection,1 had palliation resection,and 1 had interventional therapy.Conclusions Cholelithiasis may complicated with abdominal tumor,especially with digestive tract tumor.For cholelithiasis patient the history-taking need to be done carefully before operation.For the senile patient and the patient without typical symptoms or physical signs,the systems checking shoud be done carefully preoperatively,and abdominal cavity should be checked carefully intraoperatvely to find the tumor,which may exist in abdominal cavity.the patient with syndrome of post-cholecystectomy shoud be carefully followed up to avoid the mis diagnosis and mistreatment of the tumor.