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.

BackgroundAllogenic immunological rejection is still the common cause of keratoplasty failure.Organ culture is a good choice for gradually attenuating corneal antigeniciy.However,the complicated regulatory mechanism of such allogenic rejection with organ culture gratts is unclear until now.ObjectiveTo investigate the changes of several Thl/Th2 cytokines and T lymphocyte subsets in the rat corneal allogenic transplantation rejection with organ culture grafts.MethodsThirty-six SPF Wistar rats served as donors,and 72 SPF SD rats served as recipients in this study.Seventy-two SD rats were divided into two groups randomly.Organ culture and fresh grafts from Wistar rats were performed on 36 recipients SD rats,respectively.Six normal SD rats were served as the normal control.After transplantation,graft survival time was observed ; Aqueous humor levels of IL-2,IFN-γ,IL-4 and TNF-α were measured by enzyme linked immunosorbent assay.Immunohistochemistry was performed to examine CD25 expressions in grafts.Levels of TNF-αmRNA,IFN-γmRNA,IL-4mRNA and CD25mRNA in grafts were detected by using reverse transcription polymerase chain reagction.The levels of CD28subsets in peripheralblood were determined by Flow Cytometry.The use of experimental animals followed the Statement of ARVO.Results The mean rat graft survival time was longer in the organ culture grafts group( 13.78 d) than that with fresh gratts( 10.56 d)(t=14.945,P =0.000 ).The aqueous humor levels of IL-2,IFN-γ,IL-4 and TNF-α were higher in two allograft groups at day 6,day 13 and day 24 after transplantation than that in the normal control,which peaked at day 13,and the fresh grafts group had the highest level( F=324.891,416.416,240.661,364.533,P=0.000).At day 13,CD25 was weakly expressed in frozen section of two operation groups.The expression of TNF-α and IFN-γmRNA in organ culture grafts group was markedly less than in fresh grafts group at day 13 after surgeries (t =2.464,P =0.039;t=5.438,P=0.001 ),whereas there was no significient difference in IL-4 and CD25 mRNA levels between them (t=-0.782,P =0.457,t =0.712,P =0.497).The percentages of CD28 of the fresh graft group increased significantly and more weakly expressed in organ culture grafts group (P =0.016 ). Conclusions Th1/Th2 cytokines and CD28 lymphocyte subsets may play important roles during corneal allograft rejection with organ culture grafts.

Hypertensive renal damage is based on the extent and duration of hypertension, renal damage caused by varying severity. Hypertensive renal damage due to various causes imbalance of vascular active substances, renal arteriosclerosis, so that the abnormal renal hemodynamic, renal ischemia, low specific gravity of urine, low osmotic pressure and urine. The rapidly increasing incidence of hypertensive renal damage has become one of the most important reasons of end stage renal disease (ESRD). Effective treatment of hypertension is limited by poor compliance and significant adverse reaction of antihypertensive drugs. Therefore, some patients have turned to Chinese medicine (CM), hoping that such treatments might improve the efficiency. The author reviews relevant theory and the latest researches, on the basis of combining diseases and syndrome, discusses state and achievement of hypertensive renal damage with Chinese herbal medicines from fundamental and clinical research and action mechanism from standpoints of Chinese herbal compound and herbal effective chemical composition to take future research for important reference.
Antihypertensive Agents ; therapeutic use ; Disease Progression ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension, Renal ; diagnosis ; drug therapy ; Kidney ; drug effects ; Medicine, Chinese Traditional ; methods

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 assess the value of endoluminal convex array probe combined with high frequency linear array probe in diagnosis of internal carotid artery occlusion, and to improve the diagnostic accuracy rate of ultrasonography. Methods Patients suspected with ischemic cerebrovascular disease (n=490) were examined by carotid ultrasound. First, suspicious patients with carotid artery occlusion were selected using high-frequency linear array probe, then screen results were confirmed by endoluminal convex array probe and compared with previous results in those patients. Results Sixty eight patients,who were suspected of internal carotid artery occlusion,were screened out by high-frequency linear array probe. Results were re-examined by endoluminal convex array probe, 42 patients were diagnosed as internal carotid artery occlusion, 19 patients were diagnosed as severe stenosis as the internal carotid artery and 7 patients were diagnosed as ca?rotid artery tortuosity with no significant stenosis. Conclusion Endoluminal convex array probe is an effective complement for internal carotid arterial inspection when it combines with high-frequency linear probe. It can improve the diagnostic accu?racy rate of degree and the range in internal carotid artery occlusion and stenosis, therefore reduce chances of misdiagnosis.

OBJECTIVETo investigate the influence of the DNA integrity of optimized sperm on the embryonic development and clinical outcomes of in vitro fertilization and embryo transfer (IVF-ET).

METHODSThis study included 605 cycles of conventional IVF-ET for pure oviductal infertility performed from January 1, 2013 to December 31, 2014. On the day of retrieval, we examined the DNA integrity of the sperm using the sperm chromatin dispersion method. According to the ROC curve and Youden index, we grouped the cycles based on the sperm DNA fragmentation index (DFI) threshold value for predicting implantation failure, early miscarriage, and fertilization failure, followed by analysis of the correlation between DFI and the outcomes of IVF-ET.

RESULTSAccording to the DFI threshold values obtained, the 605 cycles fell into four groups (DFI value < 5%, 5-10%, 10-15%, and ≥ 15%). Statistically significant differences were observed among the four groups in the rates of fertilization, cleavage, high-quality embryo, implantation, clinical pregnancy, early miscarriage, and live birth (P < 0.05), but not in the rates of multiple pregnancy, premature birth, and low birth weight (P > 0.05). DFI was found to be correlated negatively with the rates of fertilization (r = -0.32, P < 0.01), cleavage (r = -0.19, P < 0.01), high-quality embryo (r = -0.40, P < 0.01), clinical pregnancy (r = -0.20, P < 0.01), and live birth (r = -0.09 P = 0.04), positively with the rate of early miscarriage (r = 0.23, P < 0.01), but not with the rates of multiple pregnancy (r = -0.01, P = 0.83), premature birth (r = 0.04, P = 0.54), and low birth weight (r = 0.03, P = 0.62).

CONCLUSIONThe DNA integrity of optimized sperm influences fertilization, embryonic development, early miscarriage, and live birth of IVF-ET, but its correlation with premature birth and low birth weight has to be further studied.

Abortion, Spontaneous ; Chromatin ; ultrastructure ; DNA Fragmentation ; Embryo Implantation ; Embryo Transfer ; Embryonic Development ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility, Female ; Male ; Pregnancy ; Pregnancy Outcome ; ROC Curve ; Spermatozoa ; cytology

Objective To compare the number of DARPP-32 positive cells yield in the grafts based on the application of single cell suspension by neural micro-transplantation technique and by traditional cell delivery technique and to explore effects and mechanisms of different approaches.Methods Cells derived from the whole ganglionic eminence of E15 rat embryos,ubiquitously expressing Green Fluorescent Protein(GFP) were implanted into unilaterally QA-lesioned rat striatum in a single-tract with an ultra-thin glass capillary with an outer diameter of 50 μm or using traditional cannula tip with a diameter of 500 μm.Results Histological assessment at 4 months after transplantation showed that there was about two-fold DARRP-32 positive striatal-like neurons in the micro-transplantation group(TT group) than that in the traditional group(MT group).Total graft volume was similar in both groups[(2.8±0.2) mm3 vs(2.5±0.4)mm3,F =0.25,P ＞ 0.05].And DARRP-32positive plaque volume[(0.6±0.1) mm3 vs(0.6±0.2) mm3,F =0.90,P ＞ 0.05]and TH staining plaque volume[(1.0±0.1) mm3 vs(0.7±0.1)mm3,F =1.44,P ＞ 0.05]also had the same performance in both groups.Number of DARRP-32 positive cells was calculated by Abercrombie correction formula,and the result showed that the number of DARRP-32 positive cells in MT group was two-fold of that in TT group[(20.1 ×103±1.2 × 103) vs(9.8 × 103±3.2 × 103),F =8.62,P ＜ 0.05].Higher DARRP-32 positive cells in MT group indicated that grafts had a better condition of growth and development.Conclusion Micro-transplantation approach can increase the number of new born striatal-like neurons,potentially due to the enlargement of the graft-host border area intensifying the graft's exposure to host derived factors and the minimized mechanical injury.

Objective To investigate the impact of desmoglein 3 (Dsg3) on the proliferation of peripheral T lymphocytes from patients with pemphigus vulgaris (PV).Methods Peripheral blood mononuclear cells (PBMCs) were obtained from 12 patients with PV and 22 normal human controls,cultured with or without the presence of Dsg3 or phytohemagglutinin for 3 days.Flow cytometry was performed to detect the changes of T-lymphocyte subsets in PBMCs stimulated with Dsg3 and proliferation of T-lymphocytes.Results In patients with PV,the percentage of Th2 and Th1 cells was 12.17%±5.32% and 4.08%±1.50%,respectively in Dsg3stimulated PBMCs,9.84%±5.41% and 3.91%±1.38%,respectively in non-stimulated PBMCs.Increased percentage of Th2 cells was observed in Dsg3-stimulated and non-stimulated PBMCs from patients with PV compared with those from normal human controls (both P<0.05).After stimulation with Dsg3,there was a significant proliferation of T cells from patients,and the proliferation rate of CD4+T cells was 4.65%±3.28%,which was significantly higher than that from normal controls(P<0.05).Conclusion Dsg3 can induce the specific proliferation of CD4+T cells,especially Th2 type CD+4 T cells,from patients with PV.

OBJECTIVETo investigate the values of the sperm deformity index (SDI), acrosome abnormity rate (AAR), and DNA fragmentation index (DFI) of optimized sperm in the prediction of fertilization failure (fertilization rate < 25%) in conventional in vitro fertilization (IVF).

METHODSWe selected 695 cycles of conventional IVF for pure oviductal infertility in this study, including 603 cycles of normal fertilization and 92 cycles of fertilization failure. On the day of oocyte retrieval, we examined sperm morphology, acrosome morphology, and DNA fragmentation using the Diff-Quik, PSA-FITC and SCD methods. We established the joint predictor (JP) by logistic equation and analyzed the values of different parameters in predicting fertilization failure with the receiver operating characteristic (ROC) curve.

RESULTSThe fertilization rate was negatively correlated with SDI (r = - 0.07; P = 0.03), AAR (r = -0.49; P < 0.01), and DFI (r = -0. 21; P < 0.01). The SDI, AAR, and DFI in the normal fertilization group were 1.24 ± 0.20, (7.75 ± 2.28)%, and (7.87 ± 3.15)%, and those in the fertilization failure group were 1.42 ± 0.15, (12.02 ± 3.06)%, and (13.32 ± 4.13)%, respectively, all with statistically significant differences between the two groups (P < 0.05). SDI, AAR, and DFI were all risk factors of fertilization failure ( OR = 2.68, 14.11, and 3.85; P = 0.01, < 0.01, and < 0.01). The areas under the ROC curves for SDI, AAR, DFI, and JP were 0.651 ± 0.033, 0.895 ± 0.019, 0.789 ± 0.022, and 0.915 ± 0.017, respectively. According to the Youden index, the optimal cut-off values of SDI, AAR, and DFI obtained for the prediction of fertilization failure were approximately 1.45, 10%, and 12%.

CONCLUSIONThe SDI, AAR and DFI of optimized sperm are closely associated with the fertilization rate, and all have the value for predicting fertilization failure in IVF. The AAR is more valuable than the other single predictors, but JP is more effective than the AAR.

Acrosome ; Area Under Curve ; DNA Fragmentation ; Fertilization ; Fertilization in Vitro ; methods ; statistics & numerical data ; Humans ; Male ; ROC Curve ; Risk Factors ; Spermatozoa ; abnormalities ; ultrastructure

To enhance the capacity for extending and applying appropriate health technologies in rural areas in China,this paper proposes a supportive policy system that incoperates macro,average and microlevels. Thepolicysystemfocusesonorientation, incentives, regulationsand standardization,and its objectives and measures of each level are described.The policy system will contribute to the sustainable development rural health work.