Immune checkpoint blockade is a hot spot in treatment of cancers recently,and their effi-cacy in digestive cancer cannot been ignored.Nivolumab is superior to sorafenib in the terms of prolonging survival period for the patients with advanced live cancer.The effective rate of Pembrolizumab for advanced PD-L1 positive expression esophageal cancer can reach 30%.Nevertheless,Ipilumumab shows no significant efficacy in advanced pancreatic carcinoma.More researches are on the way,such as Avelumab in advanced gastric cancer,and Pembrolizumab in advanced esophageal squamous carcinoma.

Immunotherapy has become an important therapy for solid tumors,which is in addition to surgery,radiotherapy,chemotherapy and targeted therapy.However immune treatment mechanism is different from those previous treatment.The effect of immunotherapies is on the immune system and not directly on the tumor.The kinetics of immunotherapy is characterized by a cellular immune response followed by potential changes in tumor burden and survival period.They are not captured by the traditional World Health Organiza-tion (WHO)or the Response Evaluation Criteria in Solid Tumors (RECIST).New immune-related response criteria are defined which more comprehensively capture all response patters and gradually applied in clinical practice.

Objective To observe the effect of lactobacillus vaginal capsules and Kangfuxin liquid in the treatment of senile vaginitis and the influence on vaginal environment,thus to guide rational and effective treatment. Methods 80 patients with senile vaginitis were randomly divided into observation group and control group.40 cases in the control group were given ornidazole suppository,40 cases in the observation group were given lactobacillus vagi-nal capsules and Kangfuxin liquid on the basis of the control group.Both two groups had been treated for 7d.The symptoms and signs were observed before and after treatment.The vaginal secretions were taken for measuring vaginal lactobacilli by smear method.The pH in vaginal was detected,adverse events were recorded.All the patients were fol-lowed up for six months,the recurrence was observed.Results The total effective rate,the recurrence rate of 2 months after treatment,the recurrence rate of 4 months after treatment,the recurrence rate of 6 months after treat-ment of the observation group and control group were 97.5% vs 75.0%,0.0% vs 10.0%,2.5% vs 17.5% and 2.5% vs 22.5%,the differences were statistically significant(χ2 =4.211,5.000,7.314,all P <0.05).The improve-ment of genital itching,increased vaginal discharge,dysuria,vaginal congestion in the observation group were better than the control group(χ2 =5.00,4.872,5.475,5.333,all P <0.05).The pH values of vagina in the observation group and control group were (4.4 ±1.8),(5.5 ±2.1),there was statistically significant difference(t =5.386,P <0.01).The vaginal lactobacilli positive rate of the control group after treatment was 57.5%(23 /40),which of the observation group was 87.5% (35 /40 ),the difference was statistically significant (χ2 =9.028,P <0.01 ). Conclusion The method contained lactobacillus vaginal capsules and Kangfuxin liquid can balance the vaginal envi-ronment,improve symptoms and signs,reduce the rate of disease recurrence.

To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.
●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.
●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.
●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

Objective To probe into the influencing factors and countermeasurses for clinical nursing teaching in pediatric department. Methods From June 2009 to June 2010, 86 nursing interns in pediatric department were selected, and a retrospective analysis was carried out. Results In the 86 interns in nursing practice, influencing factors of clinical nursing teaching included: 65 interns thought of department factors, accounting for 75.58%; 61 interns thought of nursing students factors, accounting for 70.93%; 59 interns thought of teacher factors, accounting for 68.60%; 57 interns thought of social factors, accounting for 66.28%. Conclusions Many factors influence pediatric clinical nursing teaching, we should strictly implement the rules and regulations and to actively take measures to comprehensively improve the quality of clinical practice for nursing students.

ObjectiveTo investigate the inhibitory effect of peroxisome proliferator-activated receptor-?(PPAR?) agonist on mesangial cell(MC) proliferation and extracellular matrix expression induced by angiotensin Ⅱ(Ang Ⅱ).MethodsThe incorporation of 3H-thymidine(3H-TdR) and cell count were used as the measurement of MC proliferation.MC cell-cycle was analyzed by flow cytometry.Mouse primary MC was treated with various concentration of Ang Ⅱ(1,10,100 nmol/L) in the presence or Absence of N-acytosistin(NAC) or rosiglitazone.Transforming growth factor-?1(TGF-?1),plasminogen activator inhibitor-1(PAI-1),and fibronectin(FN) mRNA expression were determined by real time-PCR.Reactive oxygen species(ROS) production was measured by 2,7-dichlorofluorescein diacetate(DCFDA) fluorescence.Results1.One hundred nmol/L Ang Ⅱ increased 3H-TdR incorporation and cell number by 2.14 and 2.32 fold,respectively.Ang Ⅱ-induced MC proliferation was inhibited by PPAR? agonist rosiglitazone with dose-dependent manner in mouse MC.2.One hundred nmol/L Ang Ⅱ stimulation for 24 h induced 48% MC processed to S and G2/M phase.Rosiglitazone significantly blocked Ang Ⅱ increased cell number in S and G2/M phase.3.Rosiglitazone reduced Ang Ⅱ-induced TGF-?1,PAI-1,and FN mRNA expression with dose-dependent manner.4.One hundred nmol/L Ang Ⅱ stimulation for 60 min increased ROS production by 3.85 folds.Rosiglitazone significantly inhibited Ang Ⅱ-induced ROS production.Ten ?mol/L rosiglitazone almost completely blocked Ang Ⅱ-induced ROS production.ConclusionPPAR? agonist rosiglitazone could block Ang Ⅱ-induced MC proliferation and extracellular matrix expression via inhibition of ROS production.

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Lacrimal Apparatus Diseases ; therapy ; Male ; Middle Aged

Objective To study the changes of S100βin serum and brain tissue of rats with sepsisassociated encephalopathy (SAE).Methods After placement of pole plates of electroencephalogram (EEG) on the brain cortex,thirty SD rats were randomly (random number) divided into three groups post hoc:sepsis group in which rats were made to be sepsis models by cecal ligation and puncture (n =18),normal group (n =6) and sham operation group (n =6).The sepsis-associated encephalopathy was diagnosed with electroencephalogram taken by RM6240 physiological signal recorder.Meanwhile,heart rate and blood pressure were recorded.Eight hours later,serum and brain tissue of sacrificed rats were taken for measuring S100β.The results ware analyzed with one-way ANOVA.Results Of 18 sepsis rats,3 were dead,8 without SAE and 7 with SAE.The levels of S100βin serum and brain tissue of rats with SAE group were significantly higher than those in normal group and sham operation proup (P ＜ 0.05).The Ratio of brain/serum S100βin rats with SAE group was higher than that in rats without SAE (1.74 vs 1.51,P ＜ 0.05).Conclusions Significantly high level of serum S100βwas a reliable bio-marker for diagnosis of SAE in rats.

Child, Preschool ; Coronary Aneurysm ; etiology ; therapy ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; therapy ; Thrombosis ; complications ; therapy ; Urokinase-Type Plasminogen Activator ; therapeutic use

Objective To explore the effects of different infants-feeding patterns on preschoolers' physical development, intelligence development and bone mineral density (BMD). Methods A total of 953 preschoolers from seven cities and two rural areas in China were recruited by multiple stage stratified cluster sampling methods from November 2011 to April 2012. Physiology measurement was performed to get their height and weight and to calculate body mass index(BMI). BMD of distal radius was measured by ultrasound BMD scanner. The intelligence quotient was assessed by Standford-Binet Test of Intelligence(Chinese Version). The demographic factors and the feeding ways were investigated by an interviewer-administered questionnaire and all subjects were divided into three groups : exclusive breastfeeding, mixed feeding and artificial feeding group. ANOVA analysis, Chi-square test and non-parametric test were used to analyze the data. Results There were 476, 335 and 142 children in exclusive breastfeeding, mixed feeding and artificial feeding groups, respectively. The exclusive breastfeeding rate in urban areas was significantly lower than that in rural areas [47.2%(343/726) vs 58.6%(133/227), χ2=9.780, P=0.008]. The height-for-age Z score and weight-for-age Z score were significantly different among children with different feeding ways (χ2=10.728 and 12.175, P=0.005 and 0.002). The children in the exclusive breast feeding group showed lower height-for-age Z score and lower weight-for-age Z score comparing with those in the mixed feeding and artificial feeding groups (all P<0.05). The value of speed of sound of BMD was significantly different among exclusive breastfeeding, mixed feeding and artificial feeding groups [(3 640.2±142.0) vs (3 613.9±141.9) and (3 613.4±143.0) m/s, F=3.946, P=0.020], and that in the exclusive breastfeeding group was higher than in the mixed feeding group (P<0.05). No significant difference was found in BMI-for-age Z score, intelligence score and food allergy rate and food intolerance rate among the three groups(all P>0.05). Conclusions Feeding patterns during the first several months after birth may affect the weight, height and BMD in preschool-children, but not the intelligence development of these children.