Immune checkpoint blockade can promote the tumor?specific cytotoxic T?lymphocyte ( CTL) response. However, only a small proportion of patients have good response to immune checkpoint blockade. It has been reported that radiotherapy combined with immune checkpoint blockade can promote antigen presentation, which further enhances the tumor?specific CTL response;moreover, the combined therapy achieves better treatment outcomes than radiotherapy alone or immune checkpoint blockade alone. The latest study has shown that radiotherapy combined with dual immune checkpoint blockade has better efficacy than radiotherapy combined with CTLA?4 blockade in patients with melanoma. Therefore, radiotherapy combined with immune checkpoint blockade will become a new approach for treating tumor. This paper reviews the research advances in the combined therapy.

A total of 130 anvolatory infertile outpatients were divided randomly into 4 groups of LE1 (letrozole 2.5 mg,n =45),LE2 (letrozole 5 mg,n =30),CC1 (clomiphene citrate 50 mg,n =35) and CC2 (clomiphene citrate 100 mg,n =20).The treatments started at day 5 of menstruation and lasted for 5 days.The size and number of ovarian follicles and thickness of endometrium of all 4 groups were measured starting from day 10 of menstruation.8 000-10 000 units of human chorionic gonadotropin (hCG) was injected when ovary follicles were mature.And blood estradiol (E2) was measured at the same day.Ovulation,pregnancy and adverse reaction were also monitored.The pregnancy rate was 33％ (n =15) in group LE1 and 14％ (n =5) in group CC1 with significant statistical difference (x2 =4.00,P ＜ 0.05).And there were 43 successful ovulation periods in 55 periods with an ovulation rate of 78％ in group LE1;28 successful ovulation periods in 52 periods with an ovulation rate of 54％ in group CC with significant statistical difference (X2 =4.60,P ＜0.05).E2 level (pmol/L) in the day of hCG injection in group LE1 was (774.2 ± 126.0) pmol/L and in group CC1 (963.7 ± 108.3) pmol/L,t =3.98 with significant difference (P ＜ 0.01).The number of follicle in group LE1 was 1.20 ± 0.38;CC1 2.28 ± 0.88,t =4.76 with significant difference (P ＜0.01).The thickness of endometrium in the day of hCG in LE1 was (9.6 ± 1.3) mm;CC1 (5.9 ± 1.1) mm,t =6.20 with significant difference (P ＜ 0.01).No significant statistical differences existed between LE1 and LE2,CC1 and CC2 in pregnancy rate,successful ovulation,number of mature follicles,E2 level and thickness of endometrium at the day of hCG injection.The outcomes of 36 pregnancies were 32 full-term deliveries with neonatal health,2 early abortions and 2 prematures.Mild ovarian hyperstimulation syndrome (OHSS) had a low occurrence rate.

Objective To evaluate the feasibility and efficacy of the ultrasonic technology,digital subtraction angiography(DSA) combined guide line of liver abscess drainage tube.Methods 70 patients with liver abscess received ultrasonic technology,DSA joint drainage tube after treatment.Using ultrasound technology and DSA of complementary advantages,enhancement in the operation was good,especially the liver abscess of abdominal pneumatosis was more and more room,enhancement effect was better than that of pure guided by ultrasound.Results 70 patients were all successful puncture and catheter,development was good,all 70 cases cured,without any serious complication.Conclusion Ultrasound technology,DSA joint guided puncture catheter drainage is a safe,minimally invasive treatment,has significant efficacy and important clinical value.

Circadian rhythms are endogenous 24 h variations found in virtually all physiological processes and behaviors, which are controlled by the transcriptional translational oscillator that consists of a series of core clock genes (bmal1, clock, cry and per) and clock controlled genes (rev-erbα, rorα, dbp, tef and hlf).Clock genes exist in immune organs, tissues and cells, leading to the immune cell function (migration and chemotaxis, phagocytosis, cytotoxicity and so on) and a variety of immune parameters (factor level of circulating immune cells and subsets of the relative and absolute number of cells) showing circadian rhythm changes, and playing an important role in maintaining immune homeostasis.In addition, some immune related diseases are closely correlated with circadian rhythms abnormalities.This paper will focus on the effect of circadian rhythms on immune functions and their roles in some immune related diseases.

OBJECTIVE To develop a rapid, sensitive and specific real-time PCR assay for the detection of WU polyomavirus.METHODS The VP2 gene of WU polyomavirus was selected as target gene.The specific primers and TaqMan probes according to the principle of the TaqMan real-time PCR were designed and synthesized,we optimized the PCR reaction,and detected 394 clinical samples.The sensitivity,specificity,reproducibility and dynamic range of the methods were determined.RESULTS The real-time PCR was established and applied successfully to detect the WU polyomavirus.The real-time PCR assay showed excellent linearity between the log of target input and CT value,demonstrating that the assay had a dynamic range of at least 8 logs between 1.0?100 and 1.0?107 copies;the coefficient of variation of intra-assay and inter-assay was less than 5%.Among these 394 specimens,3(0.76%) were positive for WU polyomavirus.CONCLUSIONS The real-time TaqMan PCR is a rapid,specific and sensitive method to detect WU polyomavirus.It can be used in screening large numbers of samples at the same time and establish the solid technological base for clinical diagnosis and epidemiology study.

Background The test for visual acuity is the conventional standard for evaluating visual quality.However,there is little correlation between visual acuity and visual disability.Therefore,other clinical observations such as contrast sensitivity or straylight have been used in the clinical assessment of visual quality after cataract surgery.Objective This study was to examine the change in the amount of straylight in cataractous eyes and to evaluate the correlation of the types of cataract with visual quality.Methods A non-randomized case-controlled study was designed.Eighty eyes of 40 patients with age-related cataract were enrolled in this study,including 22 eyes with hard nucleus cataract,19 eyes with cortical cataract,23 eyes with mixed cataract and 16 eyes with posterior subcapsular cataract diagnosed based on the criteria from Lens Opacities Classification System Ⅲ(LOCS Ⅲ).The values for straylight and best corrected visual acuity (BCVA) were measured with the C-quant straylight meter and Snellen chart,respectively.The differences in the straylight values among the different types of cataract were analyzed,and the correlation of the straylight value with age or BCVA was assessed.Forty eyes of 40 age-matched normal people served as controls.Results Examination was completed in sixty-two eyes of 31 patients in the cataract group at a completion rate of 77.5％,and all the subjects in the control group finished the examination at a rate of 100％.The mean straylight value was (2.06±0.88) log in the cataract group and (1.96±0.42) log in the control group,showing a significant difference between them (t =3.251,P＜0.01).The respective mean C-quant measurements for hard nucleus cataract,cortical cataract,nuclear-cortical cataract and posterior subcapsular cataract patients were (1.96±0.42) log,(1.91 ±0.16) log,(2.05 ±0.19) log and (2.48 ±0.66) log,respectively,with a significant difference among these four groups (F =2.156,P =0.019).The highest straylight value was detected in the posterior subcapsular cataract group.The straylight value was enlarged with the increase of age with a regression equation of Y=0.0010X+ 1.025 in the hard nucleus cataract group (r =0.455,P ＜ 0.05).In addition,the negative linear correlation was found between the straylight value and BCVA in both the hard nucleus cataract group and cortical cataract group (r=-0.590,-0.697,P＜0.01).However,no correlation was found in the mixed cataract group and posterior subcapsular cataract group (r =-0.240,-0.235,P＞0.05).Conclusions The C-quant straylight meter can objectively reflect the visual function for hard nucleus and cortical cataractous eye.Posterior subcapsular cataract produces straylight and exerts a great influence on visual quality due to early glare sensation,so it should be benefit to perform surgery earlier.

Objective To study the effects of allopurinol in different dose on the cardiac function of chronic heart failure rats induced by adrimycin. To explore dose-dependency of allopurinol in improving blood vessel endothe-lium function and cardiac ventricle remodeling of the rats heart, as to supply evidence and new sight in clinical treat-ment of congestive heart failure. Methods 40 Sprague-Dawley male rats were randomly divided into four groups: normal control group (group A)、model control group (group B)、low-dose allopurinol group (group C)、high-dose allopurinol group (group D). The heart failure model was made by administering adriamycin to rats. After the model myocardial pathological changes were detected. Results Compared with the normal control group, the weight and heart weight of rats in model control group and allopurinol groups were obviously lessen (group A=(300.10± 9.85)g,group B=(200.67±9.91)g, group C=(233.14±9.42)g,group D=(248.25±13.34) g;group A= (828.30±50.97) nag, group B=(681.50±16.97) mg, group C=(743.00±17.20) nag, group D=(784.88± 36.83) mg,P<0.05). Heart weight indexes were all incerased ( group A=(2.76±0.15) mg/g, group B=(3.41± 0.17) mg/g, group C=(3.26±0.76) mg/g, group D=(3.11±0.65) mg/g, P<0.05). The hemedynamics resuh showed that myocardial contractile force were enhanced in drug groups. The level of NO, SOD were increased in the allopurinol groups compared with the model control group (group B: NO=(41.55±6.28) μmol/L, group C: NO= (52.47±5.59) μmoL/L,group D:NO=(61.04±4.26) μmoL/L; group B:SOD=(63.83±6.40) U/ml,group C: SOD=(76.29±7.99) U/ml, group D: SOD=(100.13±7.43) U/ml, P<0.05) and MDA levels were obviously decreased (group B: MDA=(9.70±1.08) μmol/L, group C: MDA=(6.64±0.34) μmol/L, group D: MDA= (5.72±0.71)p.moVL,P<0.05). The level of NO, SOD were obviously increased in the allopurinol of high-dose group compared with low-dose allopurinol group(P<0.05). MDA levels were obviously decreased(P<0.05). The myocardial pathological changes were relieved obviously in the allopufinol groups. Conclusion Allopurinol improves blood vessel endothelium function dose-dependently. High-dese allopurinol obviously decreases MDA, improve NO, SOD, thereby can improve the cardiac function of heart failure.

Antibodies, Antiphospholipid ; immunology ; therapeutic use ; Antiphospholipid Syndrome ; diagnosis ; immunology ; therapy ; Child ; Humans

Objective To explore whether antibiotic prophylaxis is beneficial in tension-free in-guinal hernia repair Method A perspectiverandomized controlled study was conducted which included 1 28 patients who underwent tension-free inguinal hernia repair from July 201 1 to August 201 3.In the anti-biotic prophylaxis group,antibiotic was intravenously administrated within 30 minutes before surgery.In the control group,no preoperative antibiotic wasadministrated.The incidence of incision infection was com-pared between groups.Result Incision infectiondeveloped in onepatient of the antibiotic prophylaxis group and two patientsin the placebo group,indicating no significant difference between the groups(P >0.05).Conclusion Before tension-free repair,there is no real need to apply prophylactic antibiotics reg-ularlyfor inguinal hernia without high risk factors.

To explore the clinicopathological characteristics of parathyroid crisis.The data of 3 cases from our hospital and 125 cases reported domestically were retrospectively analyzed.All 3 cases were male.And their disease course was 3 months to 10 years.The serum calcium ranged from 3.72 to 5.19 mmol/l.Among 177 retrieved cases,125 had complete basic data.The male/female ratio was 1∶ 1.17,average age (46 ± 14) (15-75) years and average serum calcium (4.30 ± 0.58) (3.75-7.28) mmol/L.There was no difference between genders or benign and malignant pathological types.Among 117 eases with pathological diagnosis,the most common type was adenoma (74.4％).The ratio of parathyroid carcinoma was higher in males than that in females (33.3％ vs.11.7％).Misdiagnosis rate was 25.0％ upon initial presentations.Case fatality rate stood at 9.4％ (17/180) and half of them died preoperatively.