Programmed death1-ligand(PD-L1)is a new member of B7 family,whose receptor is pro-grammed death-1(PD-1). The interaction between PD-L1 and PD-1 can down-regulate the activation of immune response. There are some differences in the expression of PD-1 and PD-L1 in normal tissues and tumor tissues, which may provide a new way for the immunotherapy of carcinoma.

MicroRNA-506 (miRNA-506) is located in the X chromosome and influences various processes, such as cell proliferation, apoptosis, senescence, cell cycle, cell differentiation, epithelial-to-mesenchymal transition, angiogenesis, invasion, and metastasis, through post-transcriptional regulation of its targets. Recent studies have shown that miRNA-506 plays an important role in tumorigen-esis and progression of many types of tumors. In vitro and in vivo experiments revealed that miRNA-506 suppresses progression of sev-eral tumors and promotes response of tumor cells to chemotherapy. However, miRNA-506 plays different roles in different tumors. This review summarizes the functions and mechanisms of miRNA-506 in different tumors to identify a new target for the targeted ther-apy of certain tumors.

Objective To summarize the clinical results of combined procedure of resections and constructions of bronchus,great vessels and heart in the treatment of 79 patients with central lung cancer.Methods From Jun,1988 to Jun,2005,the combined procedure of resections and constructions of bronchus,great vessels and heart were carried out in 74 patients with central lung cancer.The operations included ring of bronchus or sleeve lobectomy in 57 cases,double sleeve lobectomy in 15 cases,carinal resection and reconstruction in 4 cases.Results There was no operative deaths and 7(8.86 %) patients had operative complications.The survival rates of 12,36,60 months and 10 years were 78.5%,59.5%,35.4% and 17.7% respectively.Conclusion With the treatment of sleeve lobectomy or combined with resection and reconstruction of pulmonary artery,great vessels or heart,the pulmonary function can be protected significantly,and the cure rate and the long term survival rate can be improved in patients with central lung cancer.

Arsenic trioxide has a significantly positive effect on the treatment of acute promyelocyte leukemia( APL) , and it also has been proved that arsenic trioxide can protect against some other kinds of malignant tumors in recent years. However, with the further research about arsenic trioxide, the reports about car-diac toxicity of arsenic trioxide are increasing. Currently, the possible mechanisms of As2 O3-induced cardiotoxicity are mainly considered to be associated with changes in cardiac ion chan-nels, oxidative stress injury and apoptosis. Research advances on cardiac toxicity of arsenic trioxide and some ways of preven-tion are summarized.

Objective To investigate the effects of stress intensity and the expected duration of stress on the inhibition ability of individual responses to stress. Methods A total of 60 cases of hospitalized patients in respiratory department were selected in the study,including 31 male cases and 29 female cases. Incorporated patients were divided into the high-stress group and the low-stress group ( 30 cases in each group) according to whether the patient accepted a invasive examination or not. Then,within each group,pa-tients were further randomly sub-divided into the acute expectation group and the chronic expectation group ( 15 cases in each group) in the form of a lottery. Detection risk disclosure was conducted at 2 hours and at 24 hours before the examination. Visual analogue scale ( VAS) and stop-signal task were used to detect the level of psychological fear and the inhibition ability of individual responses to stress of each group following informing of the detection risk,and the comparative analysis was conducted afterwards. Results ( 1) The score of psychological fear in the high-stress group was significantly increased when compared to the low-stress group ((3.90±2.71) vs (0.80±1.24)),showing statistical difference (F(1,58)=30.16, P<0.01);addi-tionally,there was no statistical difference in the score of psychological fear in subjects between the acute and chronic expectation group ((2.60±2.90) vs (2.10±2.41);F(1,58)=0.785, P>0.05);meanwhile,no statisti-cal difference of the interaction between stress intensity and the expected duration of stress on the level of psychological fear (F(1,58)=0.031, P>0.05). (2) As for stop-signal task,the signal execution error rate of the high-stress group was significantly increased than that in the low-stress group ((9.40±5.80)%vs (8.30± 12.60)%),and the statistical difference was significant (P<0.01).Signal execution responses duration was obviously prolonged in the acute expectation group than that in the chronic expectation group ((677.25±201. 26)ms vs (588.24±127.10)ms),and the difference was statistically significant (P<0.05); meanwhile,stop-signal error rate at 400 ms was significantly decreased ((57.00±26.00)% vs (70.00±23.80)%),and the difference was statistically significant (P<0.05). There was no statistical significance in the interaction be-tween stress intensity and the expected duration of stress (P>0.05) . Conclusion There is no interaction be-tween the effect of the stress intensity and the expected duration of stress on the inhibition ability of individu-al responses to stress. The stress intensity is more important than the expected duration of stress to exert more important influence in the inhibition ability of individual responses to stress.

Objective To investigate the relationship between the lifestyle actual-ideal self-discrepancy and the self-regulatory fatigue.Methods A sample of 434 healthy undergraduate students were recruited from September to October 2015.They were inquired the demographic information questionnaire,the lifestyle actual-ideal self-discrepancy of Chinese Adolescent Lifestyles Scale(CALS) and the Self-Regulatory Fatigue Scale (SRF-S).Results The scores of lifestyle actual-ideal self-discrepancy in study habits ranked the highest(1.00(0.60,1.40)),followed by physical exercise(0.86(0.43,1.29)),sleep status(0.80(0.40,1.00)),diet (0.75 (0.50,1.25)),recreational activities (0.63 (0.00,1.00)),coping style (0.50 (0.25,0.75)),interpersonal relationship (0.46(0.17,0.67)) and health habits(0.25(0.00,0.50)).Furthermore,the scores of actual-ideal self-discrepancy in interpersonal relationship,study habits,sleep,physical exercise,coping style and diet were positively correlated with the scores of self-regulatory fatigue (r=0.22,0.19,0.19,0.16,0.13,0.12,P＜0.05).There was no relationship between the scores of actual-ideal self-discrepancy and the scores of self-regulatory fatigue in health habits and recreational activities(r=0.31,0.04).Conclusion The actual-ideal self-discrepancy in interpersonal relationship,study habits,physical exercise,coping style,sleep and diet were positively correlated with the self-regulatory fatigue.The reduction in these lifestyle actual-ideal self-discrepancy may help college students ease their self-adjustment fatigue.

OBJECTIVE:To discuss the application practice of PIVAS standardization in pharmacy intravenous admixture ser-vice(PIVAS)of our hospital. METHODS:Based on JCI,the design concept and management mode of PIVAS were analyzed and summarized from PIVAS design,management,job and medical order time arrangement,staff management,infusion quality or fault emergency plan,etc. RESULTS:After introducing JCI standards,the improvement was conducted in respects of management system and work flow design,purification system and logistics division design,information system design,etc. Working hour was arranged according to the workload or work flow and the actual needs of clinical departments. Medical orders,1 batch per hour,24 batches one day,were delivered to clinical departments according the time point. The positivity of the staff had been improved, and work quantization and performance appraisal had been achieved. Those improvement optimized drug dispensing process, cleared the responsibility of information management and guaranteed the quality of infusion. Work error analysis and summary were monthly conducted;the number of work error decreased from 562 cases before JCI introduction(2013)to 264 cases after JCI intro-duction (2014),decreasing by 112.87% annually. CONCLUSIONS:JCI standard is of significance to the promotion of PIVAS management,work level and quality,and safe and rational use of drugs in the clinic.

Objective To investigate the clinical applications of the chain locking-type tension bands. Methods89 cases with patellar bone fractures,27 olecranal fractures patients,18 patients with fractures of surgical neck of humerus,16 patients with dislocation of the acromioclavicular joints and 12 patients with clavicular lateral fractures were treated with chain locking-type tension bands. ResultsTheResultsshowed that all patients wound were postoperative first intention.The healing time of the fractures were 6 ～ 18 months(average 10 months).The Kirschner's pins lapping,steel wire breaks and tension bands out of control were not found. ConclusionCompared with the traditional tension bands,the chain locking-type tension bands had stronger stability,stress distribution more even and less complications.

Background Stem cell transplantation represents a promising treatment option for patients suffering from degenerative disorders.Accumulating evidences indicate that mesenchymal stem cells (MSCs) are able to differentiate into retinal pigment epithelial (RPE)-like cells.However,MSCs are difficult to obtain.Human adipose mesenchymal stem cells (ADSCs) are proved to have similar properties to MSCs,but relevant study is less.Objective This study was to assess the feasibility of human ADSCs differentiating into RPE-like cells and the safety of its application in vivo.Methods The third generation of human ADSCs were incubated into 6-well plate,and 100 ng/ml epithelial growth factor,50 μ mol/L taurine and 5×10-7 mol/L retinoic acid were added into the medium 12 hours after cultured to induce the cells,and conventional cultured cells were used as the control group.Induced cells were traced with PKH26,and Pan-cytoke ratin (Pan-CK) monoclonal antibody was used to identify the cells under the fluorescence microscope.Induced RPE-like cell suspension of 1 μl was intravetreally injected in the right eyes of 6 BALB/c mice,and equal volume of PBS was used in the same way in another 6 mice.The animals were sacrificed 1 month after injection,and the retinal morphology was examined by histopathology under the optical microscope.The ultrastructure of retinal ganglion cells (RGCs) was examined by the transmission electron microscope.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Cultured human ADSCs grew well with the slender polygone shape.Cell membranes showed the red fluorescence for PKH26 after induced.In addition,Pan-CK was expressed in the cell membranes with the red fluorescence in the induced cells,but the response was absent in the control cells.One month after intravitreal injection,induced cells located on the retinal surface,and the retinal morphology was clear under the optical microscope.No abnormality in RGCs was seen under the transmission electron microscope.Conclusions Human ADSCs can differentiate into RPE-like cells after induction.PKH26 can mark induced cells well.There is no adverse effect of induced cells on retina after intravitreal injection in a short-term duration in mice.

Objective To investigate and analyze the mineral and bone disorder (MBD) in the patients with chronic kidney disease (CKD),reveal the change of related indexes of CKD-MBD.Methods A cross-sectional study was carried out in the First Affiliated Hospital of Harbin Medical University.From October 2011 to May 2014,1318 inpatients and hemodialysis outpatients were enrolled.Parameters related to MBD,including serum phosphorus (P),total calcium (t-Ca),intact parathyroid hormone (iPTH) and alkaline phosphatase (AKP) were analyzed.Last,it was analyzed with multiple regression analysis to related factors of the secondary hyperparathyroidism (SHPT) in patients with CKD.Results Serum calcium,phosphorus and iPTH had no obvious abnormalities at the early stages of CKD [GFR ＞ 60 ml· min-1· (1.73 m2)-1],and relatively stable before GFR ＞ 30 ml· min-1· (1.73m2)-1.After entering the CKD4 stage,serum phosphorus,iPTH increased sharply and serum calcium decreased obviously along with the decreased glomerular filtration rate (GFR).Serum P,t-Ca and iPTH levels were statistically significant in CKD 1 to 5D patients,respectively,serum P:(1.13±0.20) mmol/L,(1.14±0.22) mmol/L,(1.26±0.23) mmol/L,(1.48±0.34) mmol/L,(2.05±0.61) mmol/L and (2.08±0.58)mmol/L;serum t-Ca (mmol/L) (2.35±0.13) mmol/L,(2.35±0.12) mmol/L,(2.35±0.15) mmol/L,(2.26± 0.18) mmol/L,(2.07±0.29) mmol/L and (2.31±0.26) mmol/L;iPTH:57.8(45.6,91.8) ng/L,54.1(37.8,74.6) ng/L,71.6(45.8,102.2) ng/L,131.1(81.7,205.1) ng/L,277.5(173.6,395.3) ng/L and 354.9 (194.4,720.3) ng/L;The stepwise logistic regression analysis showed:hypocalcemia (OR=3.32,P ＜ 0.01) and decreased GFR (OR=5.28,P ＜ 0.01) were independent risk factors of iPTH elevation at stage CKD3～ 5.Conclusions From the beginning of the CKD3 stage,serum t-Ca,P,iPTH level began to be relatively abnormal as renal function declined.Hyperphosphatemia,SHPT has not been improved significantly in CKD5D stage patients even with hemodialysis.The regulation of hemodialysis on serum calcium showed overcorrecting phenomenon.