Clinical work is the core of a hospital. The level of the clinical work and scientific research are the major indexes for the evaluation of a hospital or a clinician. However, there seems contradiction between the clinical work and scientific research. For hospital administration and clinicians, it is important to adopt clinical work as the center, and conduct research around the clinical practice, which will facilitate the transition from the scientific research to clinical application. Eventually the clinical work will improve and medical science will develop.

Objective To explore the anti-tumor effect and the influence of antitumor immunity of PD-L1/PD-1 blocked by PD-1 antibody combined with cisplatin. Methods Tumor models were established by injecting TC-1 cells into C57BL/6 mice, and the mice were divided into four groups (n = 4). The tumor growth curves and survival curves were drawn to observe the anti-tumor effect. The tumors were then removed; and the PD-L1 and CD8+ T cells were analyzed by immunohistochemical method. Results The anti-tumor effect was greater in the cisplatin group , PD-1 antibody group , and PD-1 antibody plus cisplatin group than in the control group (P < 0.05). Expression of PD-L1 in the tumor tissues was markedly increased in the cisplatin group and it was obviously decreased in the combination group (P < 0.05). CD8+ T cells decreased in the cisplatin group; and expression of CD8+ T cells was significantly increased the combination group (P < 0.05). Conclusion The anti-tumor effect and anti-tumor immunity of cisplatin are enhanced by blocking PD-L1/PD-1 pathway with PD-1 antibody.

ObjectiveTo study the characteristic of apoptosis and the expression of interleukin-1β(IL-1β)and caspase-3, as well as the relation among them after spinal cord injury(SCI) in rats.MethodsAdult SD rats were divided into two groups randomly: sham group and spinal cord injury group. The rats were killed at 1 h, 8 h, 24 h, and 72h after surgery. The expression of IL-1β and caspase-3 was determined with immunohistochemistry and the apoptosis was labeled by TUNEL.ResultsThere was only a few cells that expressed low level IL-1β and caspase-3 in sham group, but they both enhanced in SCI group within 8 h after operation, and then decreased to the level similar to sham group 72 h after operation. The rates of TUNEL-positive cells were similar with that of IL-1β and caspase-3 after SCI. There was positive correlation among expression of IL-1β and caspase-3 and apoptosis index.ConclusionExpression of IL-1β and caspase-3 increase and a large number of TUNEL-positive cells present after SCI in rats, and there is positive correlation among them.

Objective To investigate the relationship between the expression of MMP-7 in peripher- al blood and esophageal cancer.Methods By using Real time RT-PCR, blood samples from 82 cases with postoperative esophageal cancer were detected.Results 37.8 %(32/82)patients were positive for MMP-7 mRNA expression.MMP-7 mRNA positivity significantly correlated with lymph node metastasis,stage,and hematogeneous metastasis.Recurrent disease was found in 28 of 82 cases. Of 28 patients experiencing re- lapse,15 patients were serially follow-up in every three months.The number positive of MMP-7 mRNA be- fore detection by imaging,at the same time of detection by imaging,and after detection by imaging was 5 cas- es,8 cases and 2 cases respectively.Conclusion Examination of MMP-7 mRNA in peripheral blood during follow-up is useful for early detection of occult recurrence.

Objective To evaluate the impact of the project diverting the Yangtze River water to the Northern Jiangsu on transmission towards the north of Oncomelania hupensis snails, in order to provide the scientific basis for the South-North Water Diversion Project (east route). Methods The running situation of the water diversion project, the data on hydrology of the waterway and the distribution of snails and schistosomiasis were investigated with the methods of epidemiology、hydrology and field test. Results There was no significant correlation between the region of waterhead and water supply on the change of snail areas. There was no significant correlation between the snail areas of the region of water supply and the volume of water diversion, either. The snail habitat was stable at the Gaoyou segment along the Grand Canal. The snail habitat in the natural place of the north of 33?15′ north latitude on the east route has not been discovered yet. Conclusion There is no sign of transmission towards north on the snail habitat at the Gaoyou segment along the Grand Canal since the project was constructed in 1961. There is no evidence that the project leads to the spread of snails and schistosomiasis, either.

Objective To compare the oxygen saturation between the blood of superior vena cava and mixed venous in lung transplantation and provide reference for monitoring method in anesthesia. Methods 30 patients who received lung transplantation were placed central venous catheter into superior vena cava and flotation catheter into the pulmonary artery in turn. The blood samples were collected from the superior vena cava and pulmonary artery for blood gas analysis simultaneously at the time of just followed the catheter placement (T1), before the resection of the first bad lung (T2), after the reperfusion of the first donor lung (T3), before the resection of the second bad lung (T4), after the reperfusion of the second donor lung (T5), before the end of the operation (T6). The oxygen saturation were compared between the blood of the superior vena cava and mixed venous. Results From T1 to T6, Bland-Altman analysis showed that the mean of deviation between the SpO2 measured in blood of superior vena cava and mixed venous were 0.5, 3.4, 2.3, 0.5, 0.27,-2.9, respectively, and the incidence beyond the upper and lowed limits of consistency zone was 3.3%, 0%, 0%, 3.3%, 3.3%, 0%respectively. The incidence of SpO2 within the consistent limits was 96.7%, 100%, 100%, 96.7%, 96.7%, 100% respectively. Conclusions The SpO2 of superior vena cava may be approximately reference as SpO2 of mixed venous during lung transplantation.

Objective To evaluate the neuroprotective effect and safety of neonatal hypoxic-ischemic encephalopathy(HIE)treated with recombinant human erythropoietin(rhEPO).Methods Fifty-three neonates with HIE were randomly divided into rhEPO treated group(n=29) with the dosage of 300 U/(kg?time),three times a week for 2 weeks and control group(n=24)without rhEPO.All supportive measures were same between 2 groups.Neurological scoring was evaluated at d3,d5 and d7 Neonatal behavioral neurological assessment(NBNA) was evaluated at d7,d14 and d28.The neurodevelopment quote was evaluated at age of 3 and 6 months.Blood pressure,liver and renal function,blood electrolytes and blood hemoglobin,platelet and reticular red blood cell count were monitored before and after treatment in all infants.Results The neurological scoring between two groups had no difference at d3.The significant difference was found at d7(P0.05).Conclusions Teraphy with rhEPO on neonatal HIE infants can promote neurological recovery,and there is no serious side effect with rhEPO treatment.

Objective To detect the type of gene mutation of thalassemia in Kunming city.Methods Sixty-three cases highly suspec-tive of thalassemia were determined with the methods of ploymerase chain reaction(PCR) and reverse dot blot(RDB) for the type of gene mutation.Results According to gene analysis,35 cases were final diagnosed from 63 cases suspective of thalassemia.Among the total,4 cases were gene deficiency ?-thalassemia,and 30 cases were gene deficiency ?-thalassemia,and there was 1 case both ?-thalassemia and ?-thalassemia.There were 9 types of gene mutation with 15 gene combinations in 35 samples.The main type of ?-thalassemia was--SEA/??,there were 6 types with 11 gene combinations from the types of genes of ?-thalassemia,the highest incidence of gene mutation was 17 site,including 17 site homozygote,heterozygote and double heterozygote.Conclusions The thalassemia invasion of Yunnan has its characters,and it is valuable to launch further research.In the same patient,there are ?-thalassemia and ?-thalassemia,it signifies that those 2 types should be diagnosed in the same time,to prevent missed diagnosis.

Objective To assess the application value of disposable syringe of low resistance (SLR) in epidural puncture.Methods One hundred and thirty-two patients scheduled to undergoing selective operation under epidural or combined epidural-spinal anesthesia were divided into glass syringe (GS) group and SLR group with 66 cases each by random digits table method.GS was applied in local anesthesia and epidural puncture with loss of resistance in GS group.While SLR was used in SLR group.The defect of the syringes' appearance was evaluated.The fastness between each sub-unit during the procedure was observed.The rupture,dropping,leakage,air leakage and blockage were also estimated.The heart rate,blood pressure,oxygen saturation and other adverse events were also observed.Results In SLR group,syringe excepted 1 case of slight resistance but did not affect the use,the rest of the components connected firmly,surface without defects,clear scale uniform color,not observed rupture,air leakage,leakage and blockage phenomenon,pump liquid and air resistance was small.In GS group,syringe surface without defects,clear scale uniform color,3 cases had loose connection,1 case with rupture when using,5 cases with air leakage and leakage,3 cases of pumping liquid or dry air resistance to 0.9％ sodium chloride and moist after use.There was significant difference in appearance and usage between two groups (x2 =10.324 5,P =0.001 3).There was no significant difference in a puncture success,first three puncture success and inject air negative pressure sensitivity between two groups (P ＞ 0.05).Conclusion SLR is worth to be applied in epidural puncture.

Objective To identify the influencing factors for the quality and efficiency of standardized resident training in order to scientifically select and train qualified resident physicians.MethodsThe exam passing rate served as the indicator to measure the quality of training; the year(s) used to pass the exam the indicator to measure the efficiency,while such methods as descriptive study,chi-square test,logistic regression,rank sum test and stratified analysis were used for data analysis and processing. ResultsThe exam passing rate of research postgraduates is lower than clinical postgraduates,the year(s) needed to pass the exam of research postgraduates is longer than clinical postgraduates. Conclusion Clinical postgraduates deserve higher priority in selecting clinicians.Research-based postgraduates shifted to clinical work require a longer training time.