Lung cancer is the leading cause of cancer-related death in the world.PD-1 is a member of the CD28 family expressed on the surface of a variety of immune cells.PD-L1, one of PD-1 ligands, plays a pivotal role in the ability of tumor cells to evade the host immune system.A recent study showed that signaling via mutant EGFR in lung tumor cells upregulates directly tumor PD-L1 expression.In this review, the clinical significance of the PD-1/PD-L1 pathway in immunotherapy for non-small-cell lung cancer (NSCLC) and the relevance to targeted therapy were summarized.

Programmed death-ligand 1 (PD-L1 ),which is highly expressed in NSCLC,can be divided into two categories:membrane PD-L1 and soluble PD-L1 .PD-L1 participates in tumor immune escape through combining with its receptor.PD-L1 immune checkpoint inhibitors have entered the phase Ⅰ studies and showed a good application prospect.It is also found that the sensitivity of PD-L1 immune checkpoint inhibitors is strongly associated with the expression of PD-L1 in tumor.Therefore,PD-L1 can be used as a biomarker to pre-dict its curative effect.

Alzheimer's disease is a common neurodegenerative disease. One of the main pathology is neurofibrillary tangles in neurons,in which principal component is the phosphorylation of tau protein. Previous studies focused on senile plaques and Aβ levels. Recent studies indicated that the development of tau protein closely associated with Alzheimer's disease, especially the abnormal phosphorylation. This paper reviewed the relationship between tau protein phosphorylation and Alzheimer's disease based on the perspective of protein kinases and phosphatases.

BACKGROUND: Natural bilogical bone-derived materials processed with physical and chemical methods possess natural network pore system. They have good cellular compatibility, and help osteoblasts attach and grow on them, and can be used as the scaffolds of osteoblasts.OBJECTIVE: To observe the osteogenetic effect of partially deproteinised decalcified bone (PDDB) as scaffolds of osteoblasts in vivo.DESIGN: A randomized and controlled trial.SETTING: Central Laboratory of the First Hospital of Kunming Medical College.MATERIALS: Partially deproteinised decalcified bone; human embryonic periosteum-derived osteoblasts; twenty 4-week-old BALB/c nude mice,with the body mass of 25 to 28 g, of either gender.METHODS: This experiment was conducted at the Central Laboratory of the First Affiliated Hospital of Kuming Medical College from January to June 2003. PDDB composited with human embryonic periostea-induced osteoblasts were implanted into the nude mice after cultured for 1 week in vivo, 4 scaffolds in each nude mouse. Composite of scalfolds and cells implanted on the left side of the spine was set as experimental side and simple implanted material on the right side of the spine was set as blank control side. Then alkaline phosphatase activity and routine histological examination were performed 4 and 8 weeks after operation.MAIN OUTCOME MEASURES: General observation, alkaline phosphatase activity and routine histological examination were performed after the materials were taken out.RESULTS: Twenty nude mice entered the stage of result analysis. ① General observation of the implanted materials: No necrosis, ecpyesis, or fluidifying was found around the implanted materials, but ingrowth and enwrapption of soft tissues were found. ② Measurement of alkaline phosphatase activity: alkaline phosphatase activity after PDDB composited osteoblasts in vivo was stronger at week 8 than at week 4 [(22.854±6.018) nkat/g vs(11.286±4.268) nkat/g], and was much stronger than that of the simple implanted materials [(1.217±0.083) nkat/g vs (2.717±0.583) nkat/g]. ③ Results of routine histological examination: Cartilage formed at week 4 and part of cartilage formed new bone and marrow cavity at week 8 at the experimental side, cartilage and new bone formed much more as time went by, but there was no any cartilage or bone formation at the control side.CONCLUSION: Cartilage and bone form after PDDB composited with osteoblasts are implanted, and more cartilage and new bone form as time passes. PDDB can be used as the scaffolds of osteoblasts.

Objective To explore the prenatal ultrasonic types ,sonographic features of malformation , ultrasonic diagnosis and prognosis of fetuses with adrenal area space‐occupying lesions . Methods Forty‐four fetuses with adrenal area space‐occupying lesions were retrospectively analyzed . Compared with postpartum neonatal special inspection results or the anatomical and pathological examination results of the corpses after induced labor ,the ultrasound types ,sonographic feature ,the key points of differential diagnosis were summarized . The newborns were followed up to 6 months after birth ,tracking the prognosis . Results Totally 44 fetuses among 166 471 fetuses(166 471 pregnant women) were detected with adrenal area space‐occupying lesions , 41 cases after delivery , including 24 cases adrenal hematoma ( 2 cases prenataly misdiagnosed as neuroblastoma) ,14 cases adrenal cyst and 3 cases neuroblastoma ,were accurately diagnosed through color Doppler or MRI or CT or pathological examination results . Three cases after induced labor , including 1 case adrenal neuroblastoma ,1 case mullerian duct cyst and 1 case adrenal hematoma( prenataly misdiagnosed as neuroblastoma ) were confirmed through the anatomical and pathological examination results of the corpses . So the conformity rate of adrenal area space‐occupying lesions was 90 .9% (40/44) . The postnatal ultrasound showed that the tumor disappeared in twenty‐four cases of adrenal hematoma without surgery ,and the longest time of the tumor disappearance was 1 year . The size of 14 cases adrenal cyst had no obvious change . One case of adrenal neuroblastoma was operated at 2 months ,2 cases were operated at 2 years of age . Conclusions Ultrasound can be used as qualitative diagnosis and differential diagnosis for fetal adrenal area space‐occupying lesions . The majority of the children with adrenal area space‐occupying lesions have a good prognosis .

ObjectiveTo summarize the ultrasonic features of endometrial carcinoma in transvaginal color Doppler sonography (TVCDS), and to analyze the supplementary function of serum CA125and CA199in diagnosing endometrial carcinoma.MethodsFrom January 2006 to October 2012, fourteen thousand and twenty-seven women underwent TVCDS in GZ Women & Children Medical Centre, serum CA125 and CA199 were determined by chemiluminescence immunoassay. The ultrasound characteristics of 131 cases of endometrial carcinoma (including 64 cases of early-stage and 67 cases of advanced endometrial carcinoma) who were accurately diagnosed by pathology and the value of serum CA125 and CA199 were analyzed.ResultsIn groups 131 patients were accurately conifrmed by pathology, including 64 cases early-stage and 67 cases advanced carcinoma. The diagnositic coincidence of ultrasound and ultrasound combined with serum tumor markers was 56.3% (36/64) and 78.1% (50/64) respectively. On ultrasonography, 64 patients with early stage endometrial carcinoma showed uterine enlargement in 38 cases and endometrial thickening in 53 cases. In 9 cases, endometrial lesions were heterogeneously hypoechoic. In 55 cases, the halo between endometrium and muscle was interrupted and disappeared. In 56 cases, endometrial lesions had muscular layer inifltration. In 13 cases, endometrial lesions had cervical inifltration. In 61 cases, sparse punctuate or reticular flow signals were detected within lesions. In 3 cases, there was no blood flow signal in lesions. All these patients had not lymph node metastasis. Sixty-seven cases with advanced endometrial carcinoma showed more obviously uterine enlargement and significant endometrial thickening. In 61 patients, tumor spread outside the uterus. Reticular or dendritic flow signals were detected in 67 cases lesions. There were hypoechoic lymph node mestastasis in 53 cases. In 31 cases of early stage endometrial carcinoma, preoperative CA125 increased. In 27 cases of early stage endometrial carcinoma, preoperative CA199 increased. In 24 cases CA125 and CA199 increased meanwhile. In 61 cases of advanced endometrial carcinoma, preoperative CA125 increased. In 59 cases of advanced endometrial carcinoma, preoperative CA199 increased. In 56 cases CA125 and CA199 increased meanwhile. Sixty-four cases of early-stage endometrial carcinoma were diagnosed by TVCDS assisted with CA125 and CA199 and were confirmed by pathology. The detective rate was 78.1% (50/64). To compared with TVCDS, the difference was statistical signiifcance (χ2=6.95,P=0.01).ConclusionsThe ultrasonic features of early-stage endometrial carcinoma in TVCDS were uterine enlargement, endometrial thickening, heterogeneous hypoechoic endometrial lesions, interrupted or disappeared hypoechoic halo between endometrium and musclar layer, and sparse punctuate or reticular flow signals within lesions. Serum CA125 and CA199 may be helpful in improving diagnosis coincidence rate when early-stage endometrial cancer is ifnd or suspected on ultrasonography.

Objective Cervical reserve cells are the maternal cells of cervical neoplasia. It's proliferation and origin were studied. Methods The pathological morphology of cervical reserve cell proliferating was observed by light microscopy in 238 cases of cervical benign diseases; Immunohistochemical technology of CD44v5 was used to inspect the expression of cervical reserve cells in 54 cases. Results and Conclusion 1.Reserve cell proliferation was common in most cases of cervical benign diseases and it was originated from stroma; 2 The proliferating reserve cells were composed of four types:large cells, small cells, clear cells and spindle cells; 3The expression of CD44v5 in reserve cells showed 100% strongly positive. The cells proliferation was common in begin diseases of cervix; Reserve cells possibly were originated from stroma.

Objective To investigate the prevalence,missed diagnosis rate and causes of acute kidney injury (AKI) in hospitalized children,and its impact on hospitalization cost,length of stay and outcome.Methods The data of children admitted in Children's Hospital Affiliated to Capital Institute of Pediatrics from December 1st to 31st 2014 were collected,and those whose serum creatinine (Scr) were measured at least two times were selected.Patients were diagnosed as AKI according to the diagnostic criteria of 2012 Kidney Disease:Improving Global Outcomes,then divided into AKI group and non-AKI group,the former of which was further divided into AKI1 group (Scr peak value in normal range) and AKI2 group (Scr peak value above normal range).The causes and impact of AKI on hospitalization cost,length of stay and outcome in different groups were compared and analyzed.Results (1) Among 921 patients with at least two Scr results,170 patients met with the diagnostic criteria of AKI,including 100 males and 70 females.There were 112(65.9％) in AKI stage 1,43(25.3％) in stage 2,and 15(8.8％) in stage 3.The overall prevalence of AKI was 18.5％.With only 7cases getting diagnosed,the diagnostic rate was 4.1％,while 95.9％ of patients missed diagnosis.(2)Among AKI patients,67 cases had pre-renal causes,103 cases had intra-renal causes and mixed factors.100(58.8％) cases got complete recovery,34(20.0％) cases recovered partially and 36(21.2％)cases did not improve,including 4 cases of death.(3) The prevalence of AKI among those below 1-year old was higher than children elder than 1-year (23.0％ vs 15.5％,P=0.004).The prevalence of AKI in surgical ward was higher than medical ward (30.7％ vs 15.8％,P ＜ 0.001).(4) Compared with those in non-AKI group,there was lower age [1.1(0.2,3.5) year vs 2.0(0.3,4.9) year] and higher hospitalization time[12.5(8.0,20.0) d vs 8.0(6.0,11.0) d],hospitalization costs [25 279.2(13 822.8,48 856.7) yuan vs 12 616.9(8680.1,19 345.1) yuan] and mortality (2.4％ vs 0.3％) in AKI group (all P ＜ 0.05).(5) There were 126 cases in AKL group and 44 cases in AKI2 group.The costs of hospitalization,outcome and mortality showed no difference between two groups (all P ＞ 0.05).The hospitalization time in AKI2 group was shorter than that in AKL group (P=0.038).Conclusions Among hospitalized children the missed diagnosis rate of AKI is high.Pre-renal factor is the main cause of AKI.Children younger than 1-year old are more susceptible to AKI.AKI children have lower age and higher hospitalization time,hospitalization costs and mortality than non-AKI children.The effect of Scr fluctuation within normal levels needs to be further studied.

BACKGROUND:Studies have shown that umbilical cord blood stem cel transplantation promote the recovery of spinal cord injury, and electroacupuncture also can inhibit the proliferation of astrocytes to reduce damage to scar formation, suggesting that a combination of umbilical cord blood stem cel transplantation and electroacupuncture may play an important role in the treatment of acute spinal cord injuries. OBJECTIVE:To observe the influence of transplantation of human umbilical cord blood stem cels combined with electroacupuncture at theDu channel on expression of nerve growth factor and neurotrophin 3 in rats with spinal cord injuries. METHODS: Seventy-two female Sprague-Dawlay rats were randomly divided into control group, injury group, transplantation group and combined therapy group. In the control group, only an incision on the back was sutured;in the injury group, a piece of saline-infiltrated gelatin sponge, 1 mm×2 mm×2 mm, was placed into the transected spinal cord at T10 level; in the transplantation group and combined therapy group, a piece of gelatin sponged infiltrated in the suspension of human umbilical cord blood stem cels was placed into the transected spinal cord, respectively, and then, electroacupuncture stimulation at the Duchannel was performed in the combined therapy group at 1 hour after modeling. Specimens were taken at 7, 14, 28 days after modeling in each group, and then immunohistochemistry, western blot and real time-PCR methods were used to detect the expression of nerve growth factor and neurotrophin 3. RESULTS AND CONCLUSION:Compared with the transplantation group, the expression of nerve growth factor and neurotrophin 3 was lower in the injury group but higher in the combined therapy group at 7, 14, 28 days after modeling (P < 0.05). The results of western blot and real time-PCR were consistent with those of immunohistochemical detection. Findings show that human umbilical cord blood stem cel transplantation combined with electroacupuncture has a remarkable synergistic effect in the treatment of spinal cord injury that can significantly up-regulate the expression of nerve growth factor and neurotrophin 3, and contribute to injured spinal cord repair, regeneration and functional recovery after spinal cord injury.

Objective To analyze mRNA expressions of 7 cytoklnes which influence the immune response in lym- phocytes in pleural effusion of non-small cell lung cancer patients to evaluate the effect of local tumor microenviron- ment on anti-tumor immune response and to explore the mechanism of tumor escape. Methods Detecting the mRNA expression of IL-2,INF-γ,IL-12,IL-18,IL-10,IL-4 and TGF-β 1 in lymphocytes in pleural effusion of non-small cell lung cancer patients and tuberculotic pleurisy patients on the single cell level by using in situ hybridization. Results In the pleural effusion of non-small cell lung cancer, the mRNA expressions of IL-10,TGF-β1 and IL-4 were signifi- cantly higher than those of IL-2,IL-12,IL-18 and INF-γ,as well as these of control group. The cytokine expression levels of tuberculotic pleurisy patients were very Iow, and there were no significant differences between different cy- tokines. Conclusion Type 2 cytokines are expressed predominantly in the pleural effusion of non-small cell lung can- cer. The increased co-expression of IL-10 and TGF-β1 indicates that they might act Jointly and play a critical role in the immunosuppression of non-small cell lung cancer.