Radiotherapy has been proven to enhance tumor-specific immune response and provide targets for immune drugs. Immune checkpoint inhibitors represented by PD-1/PD-L1 combined with radiotherapy can enhance anti-tumor activity and exert abscopal effect. In this article, research progress on the basic study and clinical trials and challenges of radiotherapy combined with PD-1/PD-L1 inhibitors in the treatment of breast cancer were reviewed.

Objective To compare the clinical value of CRP and LAC in the evaluating of diagnosis and the prognosis of se‐vere acute abdomen diseases in the elderly patients .Methods Experimental group:The blood of 92 elderly patients diagnosed with critical abdomen mass with infection and followed by surgery were collected .Then ,extracted serum was used to measure the levels of CRP and LAC ,and these patients were divided into 4 groups on base of the degree of infection:SIRS group ,sepsis group ,serve sepsis group and septic shock group .Control group:92 serums of healthy persons were selected to measure the levels of CRP and LAC .Results The CRP and LAC significantly increased in the experimental group ,when compared with the control group(P<0 .05) .The level of LAC raised with the increase severity of sepsis(P<0 .05) among groups of sepsis ,serve sepsis and sepsis with shock ,but the level of CRP had no statistical difference(P>0 .05) .Conclusion Both CRP and LAC of elderly patients diagnosed with critical abdomen mass with infection have important referential meaning .Furthermore ,the CRP has better predictability in the early stage of abdomen mass with infection .However ,to predict the severity of infection level ,LAC seems more sensitive .

Animals ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; Microscopy, Confocal ; Muscle, Smooth, Vascular ; ultrastructure

Objective To investigate the effect of ulnar nerve with or without transposition during open reduction and internal fixation of distal humerus fractures.Methods A retrospective case control study was made on 74 cases receiving open reduction and internal fixation of distal humerus fractures between January 2008 and December 2015.There were 28 males and 46 females,with a mean age of 63.2 years (range,32-83 years).AO fracture classification was A2 type in seven cases,A3 type in four,C1 type in 14,C2 type in 28 and C3 type in 21.According to the intraoperative management of the ulnar nerve,the patients were divided into transposition group (n =43) and non-transposition group (n =31).Two groups were compared with respect to operation time,Mayo elbow performance score (MEPS),incidence of ulnar neuritis and postoperative complications.Results Follow-up lasted for 6-24 months (mean,11.7 months).Operation time differed significantly between transposition group [(110.9 ± 20.8) minutes] and non-transposition group [(95.6 ± 18.9) minutes] (P ＜ 0.05).MEPS in transposition group was excellent in 15 cases,good in 20,fair in six and poor in two.MEPS in non-transposition group was excellent in 10 cases,good in 15,fair in five and poor in one,with the same excellence rate of 81％ in comparison with transposition group (P ＞ 0.05).Incidence of ulnar neuritis showed no significant difference between transposition group (9％,4/43) and non-transposition group (7％,2/31) (P ＞0.05).Postoperatively,one case of superficial wound infection and two delayed healing were noted in transposition group;one case of superficial wound infection and one delayed healing were noted in non-transposition group.There was no significant difference in incidence of postoperative complications between groups (P ＞0.05).Conclusions Ulnar nerve with or without transposition can both achieve satisfactory clinical effect during open reduction and internal fixation of distal humerus fractures.But non-transposition group is associated with shorter operation time without increasing the incidence of ulnar neuritis.

Objective To investigate the vicissitude of infection pathogens and their change in resistance to antibiotics in our hospital in the past 10 years, and to offer scientific information for clinical anti-infection treatment. Methods The data of pathogens identified and susceptibility test with VITEK system as well as K-B methods from 1995 to 2002 were analyzed. Results Gram negative bacteria was the predominance bacteria in recent 5 years, accounting for 60.7%-70.2% of all pathogens, with Pseudomonas aeruginosa ranked first, followed by Escherichia coli, Klebsiella pneumoniae, Serratia sp, Enterobacter sp and Acinetobacter sp. The ratio of Acinetobacter sp seemed to be increased in 1998, and it kept a high level in recent years. The isolation rate of Staphylococcus aureus from clinical specimens was the highest among pathogens since 1999, and 42.9%-74.5% of them were Methicillin-resistance S. aureus (MRSA). MRSA was found to be highly resistant to many antibiotics, and there was a tendency of increasing resistance to all kinds of antibiotics in Ps. aeruginosa and Acinetobacter species. Conclusion The significant changes in infectious pathogens in our hospital were an increase in S. aureus and decrease in E.coli in constituent ratios, as well as an elevation of drug resistance level of predominate bacteria. The results suggest that corresponding adjustment should be made in the strategy of infection treatment.

Objective To study the mechanism of resistance to antibiotics and disinfectants of Pseudomonas aeruginosa isolated from clinical specimens in a hospital, and to provide a reference for the use of aminoglycoside antibiotics for the treatment of P. aeruginosa infection as well as disinfection and sterilization. Methods 35 strains of multi-resistant P. aeruginosa were screened from clinical specimens by susceptibility test of agar dilution. Five kinds of aminoglycoside modifying enzyme gene and qzcE?1 gene were detected by polymerase chain reaction (PCR) method. Results The positive rates of aminoglycoside modifying enzyme genes, including aac(3)-Ⅱ, aac(6′)-Ⅰ, aac(6′)-Ⅱ, ant(3″)-Ⅰ and ant(2″)-Ⅰ, were 48.6%, 40%, 54.3%, 45.7% and 60%, respectively, and nearly all strains were positive for 2 or more than 2 kinds of above aminoglycoside modifying enzyme gene. The positive rate of qzcE?1 gene was 94.3%. Conclusions There was a close relationship between aminoglycoside modifying enzyme producing P. aeruginosa and its multi-resistance to antibiotics, The results suugested that aminoglycosides should be used cautiously, and it should be based on the result of susceptibility test in the treatment of P. aeruginosa infection, and it was inadvisable to use quaternary ammonium and biguanides disinfectant in disinfection and sterilization.

Objective To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy (DPN).Methods The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed.Among 306 patients,304 were type 2,and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years.The relationship between the electrophysiological features and clinical manifestations was evaluated.Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.Results ① NCS in lower limbs presented more abnormalities than that in upper limbs.There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9％(174/306),x2 =175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8％(24/306),x2 =1 103.1].Amplitude abnormality was more severe in sensory nerve than that in motor nerve[41.4％ (507/1 224) vs.10.8％ (132/1 224),x2 =559.2].The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9％ (280/1 224) vs.10.8％(132/1 224),x2 =1 077.4].② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4％ (33/612) vs.20.6％ (126/612),x2 =607.6].③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2％ (246/612) vs.27.3％ (167/612),x2 =129.4,P ＜ 0.001],abnormal ratio of amplitude was higher than that of the prolonged latency [30.1％ (368/1 224) vs.4.7％ (58/1224),x2 =1040.5,P ＜0.001].Among the 99 cases presenting abnormal SSR in upper limbs,32 cases were normal in conventional NCS.Among the 127 cases presenting abnormal SSR in lower limbs,7 cases were normal in conventional NCS.④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency,and negatively correlated with the nerve conduction velocity and amplitude.Conclusion Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve.Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.

Objective To detect the expression of NF‐κB ,MCP‐1 in the endometrial carcinoma and their significance .Methods The expression of NF‐κB ,MCP‐1 in 52 cases of patients with endometrial carcinoma selected from January 2003 to December 2013 , and in 16 cases of endometrial atypical hyperplasia and 19 cases of proliferative endometrial were detected by immunohistochemistry assay .The relationship and correlation between clinical pathological characteristics was analyzed .Results The expressions of NF‐κB ,MCP‐1 proteins were significantly higher in the endometrial carcinoma than those of the endometrial atypical hyperplasia and proliferative endometrial (P<0 .05) .The expressions of NF‐κB and MCP‐1 were related with histological grade and myometrial in‐vasion (P<0 .05) ,but independent of clinical stage and lymph node metastasis (P>0 .05) .The expressions of these two proteins were positively correlated(r=0 .895 ,P<0 .05) .Conclusion NF‐κB ,MCP‐1 may participate in the progress of endometrial carcino‐ma .

Objective To evaluate the clinical application and therapeutic effect of interventional embolization in treating renal pseudoaneurysms. Methods The clinical data of 11 patients with renal pseudoaneurysm, who had received interventional embolization management at authors’ hospital, were retrospectively analyzed. The embolic agents used in the embolization procedure included conventional steel coil, gelatin sponge particles, PVA, etc. All the patients were followed up for 6-24 months. Results Single renal pseudoaneurysm was found in all the 11 patients. Clinically, symptom of bleeding was seen in 3 cases. The renal pseudoaneurysm was located at the upper (n=1), middle (n=4) and lower (n=5) renal artery of the kidney, and in one case the renal pseudoaneurysm was situated at the accessory renal artery. In performing renal artery embolization, pure PVA was used in one case, spring steel coil in one case, PVA together with spring steel coil in one case, and gelatin sponge combined with spring coil in 8 cases. After the embolization, the pseudoaneurysm was no more visualized, the contrast extravasation disappeared, and the parent artery was manifested as a residual root. During the operation the patients had no obvious discomfort. Within one week after embolization therapy, 2 patients developed hemorrhage, and their hemoglobin, white blood cell count and hematocrit were significantly increased. During the follow-up period, all patients showed no recurrence signs, and routine urine tests were normal. Conclusion For the treatment of renal pseudoaneurysms, interventional embolization is minimally-invasive, safe and reliable; this technique can maximally protect the normal kidney tissue, quickly control the bleeding and effectively save the life of patient. Therefore, it is worth promoting this treatment in clinical practice.