Immune checkpoint inhibitors have become an important alternative for advanced non-small cell lung cancer (NSCLC) patients to surgery, chemotherapy, radiotherapy and targeted therapy. Monoclonal antibodies directed against immune checkpoint have shown better results in the application of first- or second-line treatment of NSCLC and for both squamous and non-squamous cell carcinoma patients, especially for those with positive PD-L1 tumor cells. Some comments will be made in present paper about the efficacy, biomarker, combined therapy and the resistant mechanism of immune checkpoint inhibitors.

Objective To investigate the effect of ginsenoside-Rgl on paraurethral fascia fibroblastsmultiplication and the expression of proliferation cell nuclear antigen (PCNA) of stress urinary incontinence(SUI) women in vitro. Methods Specimens of human paraurethral fascia were obtained from 4 SUI womenduring tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator (TVT-O) procedure.Fibroblasts were isolated and cultured by outgrowth technique. After reaching confluency fibroblasts weresubcultured every 5 days and cells after passage number 3 to 5 were used for assessment. The paraurethralfascia fibroblasts were treated with ginsenoside-Rgl at different concentrations (5, 10, 20 μmol/L) andfibroblnsts without Rgl were used as controL The multiplication conditions of paraurethral fascia fibroblastswere respectively detected by methyl thiazolyl tetrazolium (MTr) assay and the expression of PCNA byhistochemistry. Results ( 1 ) Compared with the control group, the growth rate of cells treated with differentconcentrations of Rgl after 72h [ (29±5 )%, (40±5 )%, (26±4)% respectively ] was significantly higher(P<0.01). (2)Compared with the control group, the stimulatory effect of Rgl on fibroblast growth wassignificant at 24 h (P<0.01), and peaked at 72 hi (29±5)% ,(40±5)%, (26±4)% respectively, P<0.01]. (3)Compared with the control group(28.77% ), there was a significant increase of PCNA-positivecells (P<0.01) after 48 h treatment with different concentrations of Rgl (49.24%, 83.48%, 54.50%respectively). Conclusion The results indicate that, at least in vitro, fibroblasts from paraurethral fasciataken from women suffering from SUI are able to proliferate after

Central nervous system ( CNS) injuries, such as cerebral ischemia, traumatic brain injury (TBI), and spinal cord injury (SCI), are often accompanied by complex pathological changes, and could lead to a variety of other neurological diseases.Neurons and glial cells are precisely regulated by many genes.MicroRNA ( miRNA ) are endogenous molecules discovered in recent years that regulate post transcriptional gene expression.They are highly expressed in the central nervous system and abnormal expressed under pathological conditions.They are involved in regulating variety of pathological processes after CNS injuries, and are CNS disease potential biomarkers.

Aim To explore the potential mechanism of ulinastatin’s antioxidant effect by examining the Nrf2 /HO-1 pathway.Methods OVA-induced asthma of mice was cured by intraperitoneal injection of ulinas-tatin (1 00 kU·kg -1 ·d -1 ).Control mice were given the same volume of PBS (pH 7.4).To investigate the effect of ulinastatin on airway hyperresponsiveness, levels of interleukin IL-4,IFN-γand OVA specific IgE in bronchoalveolar lavage fluid (BALF)were measured using enzyme-linked immunosorbent assays (ELISAs). The content of ROS from BALF of mice was tested in double hydrogen rhodamine (DHR)-1 23 method.The level of protein carbonyl and MDA from lung tissue of mice was detected with Protein carbonyl content assay kit and MDA kit.And antioxidative enzyme in mice BALF was tested by antioxidant enzyme kit.The levels of HO-1 in lung tissue from mice were detected by Western blot and Real-time PCR.Nuclear transfer and binding activity of Nrf2 were tested respectively by Western blot,IF and EMSA.Results Ulinastatin could alleviate the airway hyperresponsiveness,dis-tinctly reduce the content of IL-4,OVA specific IgE, ROS,protein carbonyl and MDA,but upraise the ex-pression of IFN-γand antioxidative enzyme such as SOD,GSH and TAOC. Moreover, the antioxidant effect of ulinastatin could be reversed by Znpp,which was the inhibitor of HO-1 .Ulinastatin could obviously induce the expression of HO-1 in protein level in a dose-and time-dependent manner.Ulinastatin could also induce the nuclear transfer of Nrf2 and increase the binding activity of Nrf2 as well as the expression of HO-1 in gene level;Conclusion Ulinastatin could induce the activation of Nrf2 /HO-1 pathway,which may contribute to the protective effects of ulinastatin a-gainst OVA-induced oxidative stress.

[Summary] A total of 1 510 subjects undergoing physical examination in the Central Hospital of Xuzhou were included in this study. According to the level of TSH, the subjects were divided into low TSH group(0. 30-0. 99 mIU/L,n=351), moderate TSH group(1. 00-1. 89 mIU/L, n=703), and high TSH group(1. 90-4. 80 mIU/L, n=456). Analysis of variance and linear regression were used for data analysis. The results showed that systolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , and high-density lipoprotein cholesterol( HDL-C) revealed significant differences among 3 group(P<0. 05 or P<0. 01). In the univariate linear regression model, serumTSHwithinthereferencerangewasnegativelyassociatedwithSBPandDBP(P<0.05orP<0.01),and positively associated with TG and HDL-C (P<0. 05 or P<0. 01). However, the correlations disappeared after adjustment for gender, age, body mass index, fasting plasma glucose ( FPG ) , and TG. In the multiple linear regression model, a significant negative correlation of TSH with SBP and FPG was found in males(P<0. 05).

Objective The protein kinase C ( PKC) is an essential signaling substance in the early protection of cells in pre-conditioning.This study was to investigate the role of PKC in the myocardial cells of the rat model of anoxia -reoxygenation (A-R) in-jury preconditioned with sufentanil . Methods Primary myocardial cells isolated and cultured for 5 days were allocated to a control , an A-R, a sufentanil preconditioning ( SF) , and a phorbol+sufentanil preconditioning ( PMA +SF) group.The A-R injury model was established with cultured myocardial cells from neonatal rats , which were preconditioned with sufentanil at the concentration of 0.000 3 μmol/L in the SF group or phorbol followed by sufentanil 10 minutes later in the PMA +SF group.Then the proliferation of the cells was detected , the optical density of the Cx 43 protein observed by immunofluorescence confocal technology , the apoptosis rate of the cells determined by flow cytometry, and the total Cx43 proteins calculated by Western blot. Results Cell proliferation was signifi-cantly increased in the A-R, SF, and PMA+SF groups as compared with the control (P<0.05), higher in the SF and PMA +SF than in the A-R group (0.498 0 ±0.0432 4 and 0.7240 ±0.1234 vs 0.325 8 ±0.023 5, P<0.05), and in the SF than in the PMA+SF group (P<0.05).Flow cytometry showed significantly increased rates of early , late, and total cell apoptosis in the A -R ([4.96 ±0.59], [18.77 ±0.92], and [23.73 ±0.51]%), SF ([5.86 ±0.38], [10.37 ±0.38], and [16.23 ±0.32]%), and PMA+SF group ([5.71 ±0.58], [5.54 ±0.43], [11.24 ±0.62]%) as compared with the control (P<0.05), remarkably lower in the SF and PMA +SF than in the A-R group (P<0.05), and the late and total cell apoptosis rates markedly lower in the SF than in the PMA+SF group (P<0.05). Conclusion Sufentanil has a protective effect and PKC agonists combined with sufentanil may add to the effect on myocardial cells in A -R injury.

Objective To analyze the clinical characteristics and therapy of Nocardia infection, and provide reference for clinical practice.Methods Patients with positive specimen culture of Nocardia from May 2014 to June 2016 were surveyed retrospectively, the body status, clinical features, therapeutic regimen, and prognosis were analyzed.Results A total of 10 cases of Nocardia infection were surveyed, there were 7 males and 3 females;average age was (49.90+13.75) years old.Nocardia infection occurred mostly in population with impaired immune status or underlying diseases, the main infection site was lung, compound sulfamethoxazole was the first choice drug for treatment of infection, amikacin, imipenem/cilastatin and so on were alternative choice according to disease condition, 8 patients all improved after therapy.Conclusion The diagnosis made on the basis of microbiological examination, imaging, and pathological examination, combined with comprehensive judgment according to risk factors of Nocardia infection, patient can be treated timely and rationally, and the prognosis is better.

Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus)in patients with metabolic syndrome combined with sensorineural deafness using 1 H magnetic resonance spectroscopy (1 H-MRS),and to find out the early warning indicators of sensorineural deafness in patients with metabolic syndrome.Methods The pure tone audiometry (PTA)was performed in 142 pa-tients with metabolic syndrome (diagnosed by endocrinology department),and 15 healthy subjects as the control group.The patients were divided into four groups:the metabolic syndrome group;the metabolic syndrome group with unilateral,the bilateral deafness group,and the control group.Cerebral metabolism was studied by assessing the ratios of nitro-acetyl aspartate contrast to choline (NAA/Cho)as well as to creatine (NAA/Cr),myo-inosi-tol to creatine (mI/Cr)and choline to creatine (Cho/Cr)ratios in the auditory cortical separately in these groups. ROC curves were made for those metabolism markers to find the best diagnostic threshold.Results Significantly lower values of NAA/Cho ratio and higher values of Cho/Cr were observed in metabolic syndrome in the control group (P<0.05),Cho/Cr higher than those (P<0.05).NAA/Cho ratios in the injured and uninjured auditory cortex of MS with unilateral deafness were significantly lower than those in the control group (P<0.05).A self-comparison was made between the inj ured and uninj ured auditory cortex,the result showed that NAA/Cho ratio had significant differences.All of the metabolisms were tested by the curve of ROC.The area of NAA/Cho under the ROC curve was 81%,which had a higher accuracy.NAA/Cho equating to 1 .82 could be used as the boundary indi-cators between metabolic syndrome without deafness and with deafness groups.The areas of the other indicators un-der the ROC curve were <50%.Conclusion NAA/Cho may be the early warning marker of sensorineural deafness in patients with metabolic syndrome.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate into neuron-like cells in new environment after transplantation, and then to replace damaged cells for reconstructing neural circuit. OBJECTIVE: To establish the co-culture system between rat BMSCs and neural cells in vitro, and to study the influence of neural cells on the differentiation of BMSCs into neuron-like cells in the co-culture system. METHODS: The neural cells obtained from Wistar rat fetal brain tissue and BMSCs gained from rat thighbone were co-cultured in Transwell culture plate. The morphological changes of BMSCs were observed and the special markers of neural cells in BMSCs were examined by immunofluorescence on the fifth day of the co-culture. The results were compared with control group which where BMSCs were alone cultured. RESULTS AND CONCLUSION: BMSCs in the neural cells co-culture system extended, were radial, connected each other. Neuron specific enolase immunoreactions showed positive results, showing neuron-like cells. The positive ratio of neuron specific enolase-positive cells was (33.0±10.5)%. However, BMSCs in the control group did not express neuron morphological character. Immunofluorescence exhibited that cells were negative for neuron specific enolase. These indicate that microenvironment provided by neurons improves the differentiation of BMSCs into neuron-like cells.

Definite elements is the first step of systemic analysis. Quality of thesis was determined by a combination of three factors in non-substantial dimension: ability,attitude and system. They affect the quality of undergraduate thesis in health management through different mechanisms respectively,such as selection and externalization of ability,power,adaptation,adjustment and defense of attitude,guide and regulation of system.