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 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 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 .

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.

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

Hemangioendothelioma ; complications ; Humans ; Infant, Newborn ; Kasabach-Merritt Syndrome ; complications ; Sarcoma, Kaposi ; complications

Objective To investigate SCCmec types in clinical isolates of methicillin-resistant Staphylococcus epidermidis (MRSE) carrying psm-mec.Methods We collected 165 strains of Staphylococcus epidermidis identified by automated microbiological identification system and screened MRSE by PCR amplification of esp and mecA gene.Strains with psm-mec were identified by amplification of psm-mec,fudoh and p221 DNA fragment;mec,ccr and SCCmec typing was conducted by multiplex PCR assay.Results Among 138 strains of MRSE,29 strains were identified as MRSE with psm-mec,and the carrying rate was 17.58%.Results of mec and ccr typing by multiple PCR showed that MRSE with psm-mec carried Class A mec,but the ccr type had obvious diversity.Results of SCCmec typing showed that all strains with psm-mec belonged to type Ⅱ and/or Ⅲ SCCmec.Conclusion Clinical isolates of MRSE with psm-mec carry homologous type Ⅱ and/or Ⅲ SCCmec harboring Class A mec.

Objective To estimate relationship between the brain atrophy rate and percent corpus callosum area change in patients with cerebral vascular disease.Methods Forty-six patients with cerebral vascular disease underwent MR scanning twice,at the baseline and at the end of the follow-up period.T1W images at both time points were processed automatically with structural image evaluation using normalization of atrophy(SIENA) software to determine the percent brain volume change(PBVC).In addition,the corpus callosum and the inner table of the skull on the mid-sagittal images of two scans were outlined manually to measure their areas.The percent of corpus callosum area change(PCCAC) was calculated.Then,the relationship between PBVC,PCCAC and age was statistically analyzed.Results Significant correlation was found among the three variables: spearman rank correlation coefficient was-0.295 for PBVC and age(P=0.047),while it was-0.4 for PCCAC and age(P=0.006),and 0.538 for PBVC and PCCAC(P=0.000).Conclusion SIENA software identifies brain atrophy quantitatively in patients with cerebral vascular disease,which correlated with area reduction of the corpus callosum.