恶性黑色素瘤的发病率和病死率在逐年增长，引发广泛关注。目前恶性黑色素瘤的治疗方式主要为手术、化疗和靶 向治疗，总体疗效极差。然而，PD-1抗体治疗恶性黑色素瘤的成功，使广大研究者把希望聚焦于生物免疫治疗。肿瘤浸润淋巴细 胞（tumor infiltrating lymphocyte，TIL）是从肿瘤组织分离出的淋巴细胞，经体外扩增后得到的能够杀伤肿瘤细胞的细胞群，具有 高杀瘤活性和高靶向性特点。临床试验研究发现，TIL对恶性黑色素瘤治疗效果显著且稳定，但其临床疗效尚未完全阐明。本文 对TIL免疫治疗的发展及其在恶性黑色素瘤治疗中的研究新进展作一综述，以期为恶性黑色素瘤的治疗提供新的策略。

OBJECTIVE:To explore the clinical efficacy and safety of nedaplatin combined with docetaxel in the treatment of advanced cervical cancer. METHODS:A total of 53 patients with advanced cervical cancer selected from our hospital during Apr. 2014-Apr. 2016 were divided into observation group(31 cases)and control group(22 cases)according to chemotherapy plan. Con-trol group was given Docetaxel injection 60 mg/m2,ivgtt,qw. Observation group was additionally given Nedaplatin for injection 35 mg/m2+0.9% Sodium chloride injection diluted into 500 mL,ivgtt (≥60 min),qw. A chemotherapy cycle lased for 21 d,and both groups received 2 cycles of chemotherapy. Clinical efficacies of 2 groups were evaluated 2 weeks after treatment,and the level of PCNA integal was detected before and 2 weeks after treatment. The occurrence of ADR was recorded. RESULTS:The total re-sponse rate of observation group (77.42%) was significantly higher than that of control group (63.64%),with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in PCNA integval between 2 groups(P>0.05). After treat-ment,PCNA integval of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). ADR were concentrated in grade I,and there was no statistical significance in the in-cidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Docetaxel combined with nedaplatin can significantly improve the clinical efficacy of patients with advanced cervical cancer,and does not increase the adverse reactions compared to docetaxel alone.

Objective:To explore the function of the cya gene and the preliminary mechanism of attenuated strain.Methods:The biological characteristics of cya mutant in acid and alkali resistant,salt resistance,motility,biofilm components,poisonous to the cells of epithelial cell adhesion,invasion were analysis.Results:The mobility capabilities,acid and alkali resistance and salt tolerance of cya mutant were significantly lower than the parent strain;the composition testing revealed that the cya mutant did not produce cellulose,curli and biofilm;at the same time the adhesion and invasion to epithelial cells of cya mutant had a prominent depression,and the toxicity to HeLa cells was weaker than the parent strain.Conclusion:The function of cya gene is closely related to athletic ability, penetration of cell membrane, the formation biofilm and virulence.It will provide a theory reference to the functional research of Salmonella typhimurium cya gene and the mechanism of attenuated strain.This will contribute to the development of oral vaccine using attenuated Salmonella typhimurium as vector.

Objective To observe expression levels of N-methyl-D-aspartate (NMDA) receptor and cholecystokinin (CCK) in the hippocampus and spinal cord in morphine withdrawal or tolerance mice treated by electroacupuncture or catgut embedding and explore the difference between the regulating effects of electroacupuncture and catgut embedding on morphine withdrawal and tolerance.Methods Fifty-six male C57BL/6J mice were randomly allocated to withdrawal control, withdrawal model, withdrawal catgut embedding and withdrawal electroacupuncture groups, and tolerance control, tolerance model, tolerance catgut embedding and tolerance electroacupuncture groups, 7 mice in each group. A model of morphine withdrawal was made by subcutaneous injection of morphine hydrochloride using 7-day increasing addiction method. The withdrawal control group was injected with an equal volume of normal saline at the same time points. In the withdrawal electroacupuncture group, electroacupuncture at bilateral points Shenshu was performed using a Han’s acupoint nerve stimulation device (HANS-200) at 15 min after an injection of morphine hydrochloride. In the withdrawal catgut embedding group, 0.5 cm chromic catgut was embedded in bilateral points Shenshu at 15 min after an injection of morphine hydrochloride. Addiction was promoted by intraperitoneal injection of naloxone 4 mg/kg at 10 o’clock on the seventh day’s morning and Withdrawal reactions were observed in the mice. The score was recorded using the Ryuta Tomoji opioid withdrawal symptoms evaluation scale. NMDA receptor and CCK contents in the hippocampus and spinal cord were measured by enzyme-linked immunosorbent assay (ELISA). A model of morphine tolerance was made by subcutaneous injection of morphine 10 mg/kg. The tolerance control group was injected with tolerance normal saline 10 ml/kg at the same time. In the tolerance catgut embedding group, catgut was embedded in point Shenshu at the first day after model making. In the tolerance electroacupuncture group, point Shenshu was given electroacupuncture at the first day after model making. After seven days of treatment, NMDA receptor and CCK contents in the hippocampus and spinal cord were measured by ELISA.Results There were statistically significant differences in hippocampal NR2B and CCK expressions between the withdrawal model and withdrawal control groups (P<0.05). There was a statistically significant difference in hippocampal NR2B expression between the withdrawal electroacupuncture and withdrawal model groups (P<0.05). There was a statistically significant difference in hippocampal CCK expression between the withdrawal catgut embedding or withdrawal electroacupuncture group and the withdrawal model group (P<0.05). There were statistically significant differences in spinal cord NR2A, NR2B and CCK expressions between the withdrawal model and withdrawal control groups (P<0.05). There were statistically significant differences in spinal cord NR2A and NR2B expressions between the withdrawal electroacupuncture and withdrawal model groups (P<0.05). There were statistically significant differences in hippocampal NR2A, NR2B and CCK expressions between the tolerance model and tolerance control groups (P<0.05). There was a statistically significant difference in hippocampal CCK expression between the tolerance catgut embedding and tolerance model groups (P<0.05). There was a statistically significant difference in hippocampal NR1 expression between the tolerance electroacupuncture group and the tolerance model or tolerance catgut embedding group (P<0.05). There was a statistically significant difference in spinal cord CCK expression between the tolerance catgut embedding or withdrawal electroacupuncture group and the tolerance model group (P<0.05).Conclusions Both catgut embedding and electroacupuncture at point Shenshu have a reducing effect on morphine tolerance and withdrawal. The therapeutic effect of electroacupuncture is better than that of catgut embedding.

The neuroanatomical basis of meridian effects is one of the focuses of acupuncture mechanism studies. Meridian effects depend mainly on the generation, conduction, integration and output of acupuncture information in the acupoint, spinal cord and brain.The neural tracer technique is a basic method in neurobiology. This article presents recent years' advances in the application of the neural tracer technique to acupuncture field and summarizes the types of neural tracer used in acupuncture studies and regularities in the distribution of neurons and their fibers related to labeled meridians and acupoints in spinal segments and brain regions to provide methodological reference for studies on neurobiological mechanism of acupuncture effects.

Objective:To conduct the scoping review on influencing factors of clinical nurses' perception of decent work, so as to provide a basis for future intervention research.Methods:Based on the scope review method proposed by Arksey and O'Malley, literatures on clinical nurses' perception of decent work in CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, Embase and ScienceDirect databases were retrieved. The search period was from establishment of databases to October 31, 2022. Two researchers conducted independent screening and data extraction, and summarized the included literatures and reported the results.Results:A total of 10 literatures were included, and the study showed that the factors affecting clinical nurses' perception of decent work were general demographic factors, occupation-related factors and psychological factors.Conclusions:The overall level of clinical nurses' perception of decent work is low, and its influencing factors are various. The role of some research variables needs to be further explored. Managers should take targeted measures according to the influencing factors to improve clinical nursing management and nursing service quality.

Objective To research the clinical department distribution and drug resistance of Enterobacteriaceae bacteria to pro‐vide a theoretical basis for clinical rational use of antimicrobial drugs .Methods The Whonet 5 .6 software was adopted to conduct the retrospective analysis on Enterobacteriaceae bacteria isolated in the General Hospital of Ningxia Medical University and the Af‐filiated Cardiovascular Disease Hospital from 2011 to 2013 .Results A total of 7 315 strains of Enterobacteriaceae bacteria were i‐solated ;the top three of bacteria were 2 971 strains (40 .6% ) of Escherichia coli ,2 339 strains (32 .0% ) of K lebsiella pneumoniae and 1 117 strains (15 .3% ) of Enterobacter cloacae ;in the source of specimen ,the respiratory tract specimens had the highest isola‐tion rate (46 .6% ,3 410 strains) ,followed by the pus and secretion specimens (13 .9% ,1 015 strains) ,and the urine specimens (13 .0% ,953 strains) ;the isolated bacterial strains were mainly derived from the pediatric department (17 .5% ,1 282 isolates) ,res‐piration department (7 .1% ,518 strains) and ICU (6 .4% ,468 strains) ;the highest sensitivity of antibacterial drugs were carbapen‐ems ,amikacin and piperacillin/tazobactam also maintained a good antibacterial activity ,the resistance rate was 1 .3% - 7 .6% .Con‐clusion Enterobacteriaceae has a higher isolation rate in the clinical specimens and its resistance rates to antibacterial drugs are generally higher .The surveillance on bacterial drug resistance should be strengthened so as to provide a theoretical basis for the ra‐tional use of antimicrobial drugs and effective control of nosocomial infections .

Objective To study the effect of autologous periosteum on the healing of tendon-bone interface in rabbit rotator cuff tear. Methods Supraspinatus tenotomy was performed on one side shoulder in 60 New Zealand white rabbits to establish the model of rotator cuff tear. The rabbits were randomly divided into two groups:the study group(used autologous periosteum to promote the suture fixation)and control group(simple suture fixation). The rabbits were sacrificed at 4,8 and 12 weeks postoperatively with twenty rabbits sacrificed each time. Tissue samples of the tendon-bone interface was taken for histological examination and biomechanical test was performed to assess the strength of tendon-bone junction. Results At 4 weeks the study group showed extensive inflammatory cell infiltration, and a small amount of chondrocytes and extracellular matrix. At 8 weeks, the study group showed a large amount of immature chondrocytes arranged rather regularly. At 12 weeks,the tendon bone junction appeared similar to normal. In the study group,both the tendon-bone connection and the arrangement of chondrocytes were significantly better than the control group. The result of biomechanical testing showed that the highest tendon load in the study group was significantly higher than the control group (P < 0.05). Conclusions The use of autologous periosteum as a patch to strengthen the repair of the rotator cuff tear can effectively promote the healing of tendon bone interface, shorten the rotator cuff healing time and has good biological properties. This method provides an experimental basis for clinical rotator cuff repair surgery.

The increasing focus and research on ectopic fat deposition, especially the locally impactful liver and cardiac fat, have been extensively studied. However, there has been relatively less research on renal sinus fat. The increased ectopic deposition of renal sinus fat has an independent effect on renal damage, but the underlying mechanism remains unclear. Therefore, this article will integrate current research to provide a comprehensive review of renal sinus ectopic fat deposition, covering its related imaging diagnosis, potential mechanisms influencing renal damage (mechanical pressure generated by renal sinus fat, lipotoxicity), and current interventions for renal sinus ectopic fat deposition. This is aimed at attracting more attention in clinical research to the role of renal sinus ectopic fat deposition in the occurrence and development of kidney-related diseases.

Objective: To systematically evaluate the efficacy and safety of PD-1/PD-L1 inhibitor combined with chemotherapy as comparing with chemotherapy alone for the first-line treatment of advanced NSCLC (non-small lung cancer). Methods: RCTs (randomized controlled trials) on PD-1/PD-L1 inhibitor combined with chemotherapy compared with chemotherapy alone for the first-line treatment of advanced NSCLC were searched in the PubMed, Cochrane Library, EMbase, EBSCO, Chinese Biomedical Literature Database (CBM), Chinese Journal Full-text Database (CNKI), and Chinese Scientific Journal Full-text Database (VIP). RevMan 5.2 software was used for the Meta-analysis. Results: Six RCTs with 3 238 advanced NSCLC patients were included in this study. Meta-analysis showed that the combination therapy group was more effective than the chemotherapy alone group in OS (HR=0.86, 95%CI=0.79~ 0.94, P=0.0006) and PFS (HR=0.81, 95%CI=0.78~0.84, P<0.00001). The incidence of adverse reactions, such as thrombocytopenia of grade 1-5, vomiting, diarrhea, hypothyroidism, hyperthyroidism, rash, pneumonitis, colitis, hepatitis, dysgeusia, hepatitis of grade 3-5 and colitis, in combined treatment group were all higher than those in chemotherapy alone group, the differences were statistically significant (P<0.01 or P<0.05). Conclusions: Compared with chemotherapy alone, PD-1/PD-L1 inhibitor combined with chemotherapy can significantly improve the OS and PFS of patients with advanced NSCLC in the first-line treatment, while the overall incidence of adverse reactions is higher than chemotherapy.