Breast cancer is the principal cause of death in malig-nancy women , usually treated with the combination of surgery , chemotherapy , radiotherapy and endocrinotherapy .With the de-velopment of cell biology , molecular biology , immunology, im-munotherapy becomes a new field of breast cancer treatment .In this review, we discuss new findings in breast cancer immuno-therapy , including recent successes with bispecific antibodies and immune checkpoint blockade .We also discuss therapeutic cancer vaccines and highlight several additional immunotherapy modalities in early stages of development .

A novel nucleic acid amplification method,termed loop-mediated isothermal amplification(LAMP),which amplifies DNA with high specificity,efficiency,and rapidity under isothermal conditions,may be a valuable tool for the rapid detection of infectious diseases.This method employs a DNA polymerase that have activity of strand displacement DNA synthesis and a set of four specially designed primers that recognize a total of six distinct sequences on the target DNA.LAMP can amplify a few copies of DNA to 109 in less than an hour.The final products are stem-loop DNA with several inverted repeats of the target and cauliflower-like structures with multiple loops.A positive reaction would be shown as a ladder-like pattern in a gel electrophoresis analysis.Because of the advantage,the LAMP method will be widely applied to research of nucleic acid,clinical diagnosis of infectious diseases and detection of genetically modified organisms etc.

Objective To summary the experience of surgical types selection of chronic suppurative otitis media tympano‐plasty and evaluate its clinical curative effect .Methods Chronic suppurative otitis media patient records were collected ,surgical types selection based on hearing ,otoscope and mastoid CT selection .Finally 161 chronic suppurative otitis media patients (164 ears) whoes medical records and follow‐up of contents were complete were collected ,in which type Ⅰ tympanoplasty group with 40 ears , intact bridge radical mastoidectomy+ type Ⅰ tympanoplasty group with 30 ears ,and open radical mastoidectomy+type Ⅱ tympan‐oplasty group with 94 ears .The therapeutic effects of the three surgical methods for the treatment of chronic suppurative otitis media were evaluated from hearing ,quality of life as well as satisfactory score after surgery .Results The mean values of the air conductive hearing thresholds after operation in the three tympanoplasty groups were decreased than those before operation (all P<0 .05) ,while the mean values of the bone conductive hearing thresholds after operation showed no obvious changes (all P>0 .05) .There were no statistically significant improvements in the air conductive hearing thresholds in the three tympanoplasty groups (P>0 .05) .The improvements in patient′s subjective hearing of the there surgical methods were 82 .5% ,70 .0% and 83 .0%respectively ,there was no statistically significant (P>0 .05) .The improvements in the overall quality of life of the three surgical methods were 80 .0% ,80 .0% and 79 .8% respectively ,showed no statistically significant differences (P>0 .05);the reduction rate of patient′s worry about illness were 90 .0% ,93 .3% and 95 .7% ,showed no statistically significant differences (P>0 .05);the bas‐ic satisfaction rates in the postoperative satisfaction ratings of the three surgical methods were 100 .0% ,100 .0% and 97 .9% ,and there were no statistically significant differences (P>0 .05) .Conclusion For tympanoplasty in chronic suppurative otitis media pa‐tients ,surgical types selection based on hearing ,otoscope ,mastoid CT selection and intraoperative findings .From the evaluation of postoperative patients with hearing and quality of life ,three surgical methods of chronic suppurative otitis media Tympanoplasty a‐chieve satisfactory results .

OBJECTIVE:To optimize the decolorization condition for polysaccharide extract of Mongolian medicine Vicia amoena,and to establish the method for its extraction and content determination. METHODS:The water extract-alcohol precipita-tion was used to extract polysaccharide from Mongolian medicine V. amoena. Using decolorization rate as index,orthogonal test was designed to investigate the effects of the dosage of activated carbon,decolorization temperature,decolorization time on the de-colorization of polysaccharide,so as to optimize the conditions for the decoloration of polysaccharide. Using glucose as control, phenol sulfuric acid method was adopted,and the content of polysaccharide in crude polysaccharide was determined by UV spectro-photometry at 490 nm. RESULTS:The optimal decoloration condition was as follows as actived carbon of 3%,decoloration time of 40 min,decoloration temperature of 60 ℃. On this basis,the average decolorization rate reached 19.77%(RSD=1.85%,n=3) by the verification test of the decoloration. The average extraction yield for the crude polysaccharide was 4.56%(RSD=2.38%,n=3),of which the polysaccharide content was 1.98%(RSD=2.18%,n=4). CONCLUSIONS:This experiment has relatively good reproducibility in polysaccharide yield;established method for content determination of polysaccharide is stable and feasible.

Objective To investigate the efficacy of medial plantar flaps with cutaneous nerves on fixing palm skin defects for patients injured while working.Methods All cases with palm skin defects who received medial plantar flaps grafting from June 2003 to January 2013,were analyzed retrospectively.The data included 13 males and 10 females,with the mean age of 36 years old (range,18-61 years old).There were 16 cases with right hand injury and 7 cases with left,whose skin defects ranged from 3.6 cm×2.8 cm to 7.0 cru×5.5 cm.All cases had skin and soft tissue injury while 5 cases with vascular and nerve injury,3 cases with tendon involvement and being exposed,6 cases with open metacarpal fractures.15 patients were treated with emergency surgery within 8 hours after injury,while 8 patients were treated 10 days after debridement surgery.Results Altogether,23 patients who received medial plantar flaps grafting operations,with palm skin defects,were included in this study.All cases were followed up for 3 to 36 months with a average period of 18 month.The grafted flaps range from 4.6 cm×3.8 cm to 8.0 cm×6.5 cm.Among the patients,19 of them recovered excellently with healing by first intention,with 7-14 d healing time,fully-retained hand functions and palm appearance,and 4-8 mm for between two points distinguish test.Flaps survived fairly well in 3 patients because partial necrosis happened at plantar skin graft donor site.After being debrided and dressed,the wound healed at second phase with a healing time of 12-21 d and 5-9 mm for between two points distinguish test.The operated hands could flex and extend functionally in the follow-up period.Only one patient did not recovered from medial plantar flap grafting and the flap did not survive operationally.The patient recovered after another operation with groin skin grafting later.According to Gu Yudong et al' evaluation criteria,such as improved hand function,19 cases were scored as excellent recovery,3 cases as good,and 1 as poor.The excellent rate was 95.7％ (22/23).Conclusion Medial plantar flaps with cutaneous nerves are ideal flaps for palm skin defects restoration,which characterized by the advantages of fixed anatomical position,high survival rate and being good to the functional recovery and palm appearance.

Objective:To investigate the effect of steroid hormones on distribution of uterine natural killer(uNK)cells in the mouse uterus.Methods:A unique uNK cell marker, Dolichos biflorus agglutinin(DBA)lectin was used to localize uNK cells in the ovariectomized and ovarian steroid hormone-treated mouse uterus by immunohistochemical staining.Results: After estrogen(E_2)was administered in the ovariectomized mice, uNK cells were distributed in the stroma of uterine mesometrial pole,as round, immature and small lymphocyte-like cells.With the progesterone(P_4)administered, the immunostaining results showed that DAB-lectin staining were mainly distributed in the vascular endothelial cells.With the combination of E_2 and P_4, DAB-lectin staining was distributed in the matrix of the uterus,seen as a number of small round uNK cells or some as vascular endothelial cells.The effects could be completely abolished by specific antagonists of their nuclear receptors(estrogen and progesterone receptor).Conclusion: The distribution of uNK cells in mouse uteri is collaboratively regulated by estrogen and progesterone.The endometrial uNK cells may be involved in the mechanism of the fetal protective immune reaction during pregnancy.

The effects of ketamine on transient outward potassium current (I(to)) of isolated human atrial myocytes were investigated to understand the mechanism of part of its effects by whole-cell patch-clamp. Atrial myocytes were enzymatically isolated from specimens of human atrial appendage obtained from patients under going cardiac valve displacing. Ito is recorded in voltage-clamp modes using the patch-clamp technique at room temperature. Currents signals were recorded by an Axopatch 200B amplifier with the Digidata 1322A-pClamp 9.0 data acquisition system. Ketamine decreased I(to) of human atrial myocytes in a dose-dependent manner. The current-voltage curve was significantly lowered, 30, 100, 300, and 1000 micromol x L(-1) ketamine decreased respectively I(to) current density about (13.62 +/- 0.04)%, (38.92 +/- 0.05)%, (72.24 +/- 0.10)% and (83.84 +/- 0.05)% at the potential of 50 mV, with an IC50 of 121 micromol x L(-1). The I(to) activation curve, inactivation curve and the recovery curve were not altered by ketamine. So, ketamine concentration-dependently decreased I(to) of human atrial myocytes.

Objective To analyze the quality of life among adults with chronic suppurative otitis media,and to research the chan-ges of the life quality between preoperative and postoperative.Methods We modified the chronic ear survey(CES)through inter-view adults with chronic suppurative otitis media.The modified scale (Chronic Suppurative Otitis Media Outcome Survey)was ad-ministered to 110 patients in a prospective manner,and then was validated according to established criteria for reliability and validi-ty.Then we assessed the outcomes of surgeries for chronic suppurative otitis media.Results The chronic suppurative otitis media outcome survey includes 17 entries,and was divide into four dimensions.Excellent test-retest reliability was obtained for the survey score (R=0.967).Cronbach′s α correlation coefficient were calculated as 0.864 for the total survey.Criterion validity showed a high correlation between scores on chronic suppurative otitis media outcome survey and scores on CES (R=0.977,P <0.01).U-sing principal components extraction with orthogonal rotation,it was performed on the composite data set,and this yielded a four-factor solution that explained 70.394% of the variance.The average score of patients before surgery was 51.660±10.762,post-op-erative scores was 75.893 ± 7.734.The total score wasn′t significantly changed after the surgery,and the average value was 24.23±7.67 (t=24.653,P <0.01).Conclusion The chronic suppurative otitis media outcome survey is a reliable and valid meas-ure of quality of life for adults with chronic suppurative otitis media,and it is more suitable than the CES in outcomes studies and clinical trials.

OBJECTIVEThe metabolic character of tetramethylpyrazine (TMPz) in rat liver microsomes was studied in vitro and in vivo to identify which isoforms of cytochrome P450 were responsible for TMPz metabolism in rats, offer the theoretical foundation for the fact that it is rational to use medicine in clinic.

METHODSet up UV- HPLC method of TMPz, determine concentration of TMPz and its formation in rat plasma and liver microsomes incubation solution, analyze the correlation between TMPz's metabolic eliminate rate and each inducer. Erythromycin( ERY) N-demethylase activity of each sample in rat liver microsomes was measured using N-demethylation reaction of ERY as probe. The correlation between the rate of TMPz metabolite formation and the demethylase activity was analysed. After the SD rats who had been treated with inducer, inhibitor, or untreated, received administration of TMPz in vein, the plasma concentration of TMPz were determined by HPLC. Pharmacokinetic parameters of TMPz were computed and compared.

RESULTThe disppearing rate of TMPz in the incubation solutions of the rats liver microsomes, which treated with DEX, were markedly quicker than that of control group (P < 0. 01) , while no obvious difference between P-NF group or PB and control group was observed (P > 0. 05). The activity of ERY-N-demethylase in DEX-induced group was corespondingly enhanced, was much higer than that in control group. The correlation between the rate of TMPz metabolic product formation and the activity of N-demethylase was significant. After using Ket, the CYP3A inhibitor, the metabolism of TMPz could be significantly inhibited the metabolism of TMPz in rat liver microsomes. In vivo, CL( s) were larger than that of the control group,t,/2 were smaller than the control group in DEX group; By contrary, CL(s) was smaller than the control group,t1/2 was larger than the control group in Ket group.

CONCLUSIONResults suggest that CYP3A plays a major role in TMPz metabolism in rats, TMPz lie in the possibility of Interaction among the medicines between TMPz and CYP3A inducers or inhibitors when they are used in clinic.

Animals ; Cytochrome P-450 CYP3A ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; Dexamethasone ; pharmacology ; Ketoconazole ; pharmacology ; Male ; Metabolic Clearance Rate ; Microsomes, Liver ; drug effects ; enzymology ; metabolism ; Pyrazines ; blood ; metabolism ; pharmacokinetics ; Random Allocation ; Rats ; Rats, Wistar ; Vasodilator Agents ; blood ; metabolism ; pharmacokinetics

The treatment of lower extremity chronic refractory ulcers requires a long time but with poor prognosis. Thus, many patients end up with amputations. The treatment of lower extremity chronic and recalcitrant ulcers and limb salvage has been a challenge worldwide. The Ilizarov technique based on the law of "tension-stress" brings a new hope in treating lower limb chronic and recalcitrant ulcers. The Ilizarov technique and distraction osteogenesis not only induce bone formation but also lead to angiogenesis and improved microcirculation. The Ilizarov technique consists of longitudinal distraction of long bone and tibia trans-verse transport (TTT) (proximal tibial corticotomy followed by transverse distraction). These two techniques have their own advantages and disadvantages with different indications in clinical application. Longitudinal distraction of long bone is mainly used for bone formation, such as large bone defects, osteonecrosis or bone infection (with or without soft tissue loss or ulcers). Because of only a partial osteotomy in TTT, the trauma is minor and their effects on limb instability are limited. Moreover, the procedure is simple with only a few minor complications. Thus, it is ideal in treating lower limb ischemic ulcers, such as diabetic foot ulcers, thromboangiitis obliterans (Buerger's disease), ulcers caused by atherosclerotic occlusion, arterial or venous ulcers, and trauma wounds. Several studies reported that TTT achieved high healing and limb salvage rates in treating severe diabetic foot ulcer. However, TTT could achieve lower recurrent rate. Thus, it is the most successful application in treatment of chronic ulcers. TTT also improves healing and limb salvage in treatment of thromboangiitis obliterans. However, the overall effects are limited than those in treating diabetic foot ulcer. For lower limb atherosclerosis occlusion, TTT induces regeneration of microvessles and consequently leads to ulcer healing. The effects are better than other conventional treatments. A combination therapy with vascularization is emphasized to attain the optimal long-term effects. The effects of TTT on lower limb recalcitrant ulcers still need to be validated in randomized control trial with larger sample size. Further, the mechanism of treatment needs to be explored by pilot studies which could show that this may be related to the formation of pro-angiogenetic factors and a rebalance of the inflammatory microenvironment during TTT.