Objective The study aimed to investigate the clinical value of serum soluble ST2 (sST2) and galectin-3(gal-3) in dilated cardiomyopathy(DCM) patients associated with heart failure.Methods 60 DCM patients with heart failure were collected in Anzhen Hospital Department of Cardiology from June to December 2017 as researching group.52 coronary heart disease(CHD) patients with heart failure were as the controls,also,70 healthy controls were analyzed by cross-sectional investigation.In DCM group,18 patients (male/female:11/7) were enrolled in the NYHA(New York Heart Association) cardiac function Ⅰ-Ⅱ group and 42 patients (male/female:32/10) were enrolled in the NYHA cardiac function Ⅲ-Ⅳ group.sST2 was detected by enzyme-linked immunoassay;gal-3 was detected by chemiluminescence immunoassay.One-Way ANOVA,non-parametric test,Spearman linear correlation analysis and other statistical methods were used in our study.Results Compared with healthy controls,the serum level of sST2 in DCM group increased markedly [21.23(14.59,25.29) ng/ml vs 14.59(12.78,17.16) ng/ml,standardized H=-4.645,adjusted P＜0.001],and significantly higher serum level of gal-3 [13.50(10.48,19.68) μg/L vs 10.05(8.25,12.80) μg/L,standardized H=4.266,adjusted P＜0.001].Compared with CHD group,there was a significant increase [13.50(10.48,19.68) μg/L vs 11.00(8.65,13.58) μg/L,standardized H=-2.715,adjusted P＝).020] in the expression of serum gal-3 in DCM group.The serum level of sST2 in cardiac function Ⅲ-Ⅳ group was obviously higher than that in the Ⅰ-Ⅱ group [22.54(16.82,26.78) ng/ml vs 12.24(9.22,17.79) ng/ml,Z=2.613,P＝0.009].Spearman correlation analysis showed a negative correlation between sST2 and left ventricular ejection fraction(LVFE) (r=-0.647,P＜0.01),but a positive correlation between left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic dimension(LVESD) (r=0.393,r=0.462,all P＜0.01).The correlation of sST2 and B-type natriuretic peptide(BNP)/gal-3 (r=0.320,r=0.331,all P＜0.05),gal-3 and high-sensitivity troponinI(hs-TnI)/BNP(r=406,r=0.401,all P≤0.01) presented the same.There was a inverse correlation between gal-3 and estimated glomerular filtration rate(eGFR)(r=-0.326,P＜0.05).ROC analysis showed that the cutoff of sST2 was 21.00 ng/ml,with 51.9％ sensitivity and 95.7％ specificity (AUC=0.745,95％ CI:0.652-0.838,P＜0.001),and the cutoff of gal-3 was 13.15 μg/L,with 53.7％ sensitivity and 85.7％ specificity (AUC=0.720,95％ CI.0.627-0.812,P＜0.001).Combined detection of BNP/hs-TnI may remarkably improved the sensitivity (up to 95.3％).Conclusions The serum levels of sST2 and gal-3 were significantly increased in dilated cardiomyopathy patients with heart failure.It showed a strong relation between sST2 and the deterioration of cardiac function,and a certain correlation with left ventricular remodeling.Although the diagnostic value of DCM was lower than that of BNP,sST2 may not be affected by age,body mass index and the damage to kidney function.Combined diagnosis could dramatically improve the diagnostic efficacy.

As a new noninvasive molecular biomarker, plasma cell-free DNA (cfDNA) has potential value in early diagnosis, prognosis evaluation, therapeutic monitoring. Now lots of methods can be used to detect cfDNA including SSCP-PCR, RFLP-PCR, sequencing, and digital PCR. Different methods could be applied in screening of unknown mutations, analysis of genetic polymorphism, and anlysis of specific mutations. cfDNA can be applied in early screening and evaluation in cancers, prenatal test, cardiovascular diseases, and transplantation. This manuscript reviewed the detective value of cfDNA on different diseases.

Objective To explore the association between carotid artery plaque and small dense low-density lipoprotein cholesterol(sdLDL-C)concentrations as well as the probability of sdLDL-C and sdLDL-C/LDL-C ratio as biomarkers of human carotid atherosclerotic plaque.Methods 174 subjects in physical examination center of An Zhen Hospital from November 2015 to February 2016 were enrolled one by one as a cross-sectional study.All subjects were divided into carotid IMT abnormal group(n=92)and control group(n=82)according to carotid ultrasound.According to the thickness of IMT characterized by carotid ultrasound,subjects were divided into the thickened IMT group(n=32), plaques group(n=60), and plaques group were divided into single plaque group(n=33)and multiple plaques group(n=27).Body Mass Index(BMI), fasting serum sdLDL-C, triglyceride(TG), LDL-C and high-density lipoprotein cholesterol(HDL-C)concentrations were measured.Pearson′s and Spearman correlation coefficient analyses and logistic regression analyses were used to examine the relationships between carotid atherosclerotic plaque,sdLDL-C values,and other clinical variables.Area under curve(AUC)was calculated to determine the diagnostic value of sdLDL-C and sdLDL-C/LDL-C ratio in subjects with carotid atherosclerotic plaque. Results Levels of sdLDL-C(1.02 ±0.42 vs.0.97 ±0.46 vs.0.61 ±0.29, F=21.07, P<0.001)and sdLDL-C /LDL-C(0.34 ±0.17 vs.0.34 ±0.17 vs.0.21 ±0.09,F=16.34,P<0.001)in the thickened IMT group and the plaques group were higher than those of the control group).Even in individuals considered to be at low LDL-C(<2.59 mmol/L)level,sdLDL-C(0.94 ±0.41 vs.0.56 ±0.25,t=4.00, P<0.01)and sdLDL-C/LDL-C ratio(0.43 ±0.19 vs.0.24 ±0.08,t=4.45,P<0.01)remained higher in the carotid abnormal group than those in the control group.Age and sdLDL-C were the independent risk factors of carotid artery plaque.AUC of receiver operator characteristic curve(ROC)for serum sdLDL-C and sdLDL-C/LDL-C ratio were 0.882(95% CI:0.819-0.945, P<0.01)and 0.830(95% CI:0.747-0.914,P<0.01)to determine the multiple carotid atherosclerotic plaque,and the cut-off level were 0.90 mmol/L(sensitivity,88.0%;specificity,79.3%)and 0.30(sensitivity,84.0%;specificity,74.5%). Conclusions Carotid atherosclerotic plaque has a close relationship with sdLDL-C concentrations.sdLDL-C and sdLDL-C/LDL-C ratio can be biomarkers when assessing subjects with a carotid atherosclerotic plaque.

Objective To evaluate the clinical value of iohexol contrast agent in patients with malignant tumor by spiral CT scan combined with endoscopy.Methods 100 patients with pathologically confirmed malignancies were selected and randomly divided into two groups, with 50 cases in each group, the experimental group received iodohexanol contrast agent combined with spiral CT scan and endoscopy , the osmotic pressure of iohexol at 37℃600 mOsm/kg, 5 minutes before the injection of intravenous injection of 10 mg prophylaxis of dexamethasone, and then spiral CT scan was performed.The control group were treated with diatrizoate contrast agent combined with spiral CT scan and endoscopy.The osmotic pressure of diatrizoate was 1500 mOsm/kg at 37℃, and 10 mg of prophylactic drug dexamethasone was injected intravenously 5 minutes before the injection.And then a spiral CT scan was performed.Results The adverse reaction in experimental group was 4%, which was mild compared with 12% in control group ( P<0.05 ) .The tolerance and spiral CT image quality of experimental group were better than those of control group ( P<0.05 ) .Conclusion Iohexol contrast agent, whether adverse reaction or image quality than the effect of diatrizoate contrast agent , in the spiral CT scan combined with endoscopy in patients with malignant tumors of higher clinical value, can be more accurate diagnosis of malignant tumors.

Objective To analyze functioning and disability, unmet needs and the service for people with disabilities in Shenzhen, Guangdong, China. Methods Based on International Classification of Functioning, Disability and Health (ICF) and World Report on Disabil-ity, the theoretical framework had been constructed, and the unmet needs and service status for people with disabilities in Shenzhen in 2015 had been statistically analyzed. Results For the statistics of disability by categories, physical disability composed of 42.5%, speech disability composed of 1.5%;people with severe and extremely severe disabilities composed of 52.8%;Futian District composed of 19.7%, Yantian District composed of 2.2%;people aged 0 to 18 years composed of 17.4%, and people aged over 60 years (27.0%) were the larger group. For the unmet needs of people with disabilities, 25%needed rehabilitation therapy, 18.8%needed functional training, 23.2%needed assis-tive devices, and 32.9%had no need. For rehabilitation sevice in Shenzhen, 24.4%received rehabilitation therapy, 17.4%received function-al training, 20.4%received assistive devices, and 37.6%did not receive any service. For the barrier-free reconstruction, 4.6%needed bath-room reconstruction, and 0.7%needed internet access screen software. Conclusion The status of functioning and disability, unmet needs and service development of rehabilitation in Shenzhen had been analyzed. There was still a gap between unmet needs and services of rehabilita-tion. It recommended to construct precise services delivery based on unmet needs, improve the full coverage and quality of service of reha-bilitation.

Objective To verify the feasibility of discriminating tissue types in the anterior approach of the cervical spine by the Electrical impedance (EI) and decrease the rate of severe complications.Methods Six New Zealand white rabbits and 6 mini-pigs were performed standard anterior cervical surgery.The esophagus,carotid artery,tracheal cartilage,annular ligaments of trachea,longus colli muscle and anterior longitudinal ligament are classified as the prevertebral group;The cortical bone,cancellous bone,anulus fibrosus and nucleus pulposus are classified as the vertebral group.Once all the tissues were exposed completely,over the frequency range of 200-3 000 kHz (the frequency points were 200 kHz,400 kHz,600 kHz,800 kHz,1 000 kHz,2 000 kHz,3 000 kHz),the in vivo EI of prevertebral group and vertebral group were measured by a probe and a precision inductance-capacitance-resistance (LCR) meter;then the data were analyzed with IBM SPSS Statistics 22 software.At every frequency,Kruskal-Wallis test followed by all pairwise multiple comparisons was applied for all the four groups (the prevertebral group of rabbits,the vertebral group of rabbits,the prevertebral group of mini-pigs,and the vertebral group of mini-pigs),respectively.P values ＜ 0.05 were considered statistically significant.Results At every frequency,the results of Kruskal-Wallis test for all the four groups were significant,and the results of multiple comparisons were as follows.(1) In both miniature experimental animals and large experimental animals,the EI of the vertebral group tissues was significantly different at every investigated frequency (multiple comparisons).(2) In the miniature experimental animals,the EI between longus colli muscle and esophagus,carotid artery and annular ligaments of trachea,and tracheal cartilage and anterior longitudinal ligament had no significant difference at any frequency (multiple comparisons);significant difference could not be detected in the EI between anterior longitudinal ligament and annular ligaments of trachea at the frequencies of 2000-3 000 kHz (multiple comparisonsk) and could be detected at the frequencies of 200-1 000 kHz (multiple comparisons);for comparison of all other paired tissues of prevertebral group there were significant differences at all frequencies (multiple comparisonsk).(3) In the large experimental animals,the EI between longus colli muscle and esophagus,carotid artery and annular ligaments of trachea,and tracheal cartilage and anterior longitudinal ligament had no significant difference at any frequency (multiple comparisons),the same was true for the EI between annular ligaments of trachea and esophagus,carotid artery and anterior longitudinal ligament,and longus colli muscle and annular ligaments of trachea at the frequencies of 800-3 000 kHz,3 000 kHz and 3 000 kHz (multiple comparisons),respectively;for comparison of all other paired tissues of prevertebral group there were significant differences at all frequencies (multiple comparisons).Conclusion At certain frequencies,the EI among tissues was significantly different and could discriminate tissues in the anterior approach of the cervical spine.

Antibody-based PD-1/PD-L1 blockade therapies have taken center stage in immunotherapies for cancer, with multiple clinical successes. PD-1 signaling plays pivotal roles in tumor-driven T-cell dysfunction. In contrast to prior approaches to generate or boost tumor-specific T-cell responses, antibody-based PD-1/PD-L1 blockade targets tumor-induced T-cell defects and restores pre-existing T-cell function to modulate antitumor immunity. In this review, the fundamental knowledge on the expression regulations and inhibitory functions of PD-1 and the present understanding of antibody-based PD-1/PD-L1 blockade therapies are briefly summarized. We then focus on the recent breakthrough work concerning the structural basis of the PD-1/PD-Ls interaction and how therapeutic antibodies, pembrolizumab targeting PD-1 and avelumab targeting PD-L1, compete with the binding of PD-1/PD-L1 to interrupt the PD-1/PD-L1 interaction. We believe that this structural information will benefit the design and improvement of therapeutic antibodies targeting PD-1 signaling.
Antibodies, Monoclonal ; immunology ; therapeutic use ; Antibodies, Monoclonal, Humanized ; immunology ; therapeutic use ; B7-H1 Antigen ; antagonists & inhibitors ; immunology ; Humans ; Neoplasms ; drug therapy ; immunology ; pathology ; Programmed Cell Death 1 Receptor ; antagonists & inhibitors ; immunology ; Signal Transduction ; drug effects ; immunology ; T-Lymphocytes ; immunology

Objective To investigate the correlation between eigenvalues(λ∥ andλ⊥)of sciatic nerve and limb function in a rabbit model of acute nerve traction inj ury for finding the role ofλ∥ andλ⊥ on diagnosis of nerve inj uries.Methods The right sciatic nerves of 32 Newland rabbits were selected to be performed as traction injury,and then left sciatic nerves were treated as control for the sham operation side.MRI DTI scan was performed before and after the operation on 1 day ,3 day,and 1 week,2,3,4,6 and 8 weeks respectively.Theλ∥ andλ⊥ of inj ured sciatic nerves and sham operated nerves were measured,meanwhile functional exami-nations were evaluated,and then analyzing the correlation betweenλ⊥ of inj ured sciatic nerves and the score of inj ured limb function in the periods of 3 days to 8 weeks;finally different portions of sciatic nerve were removed for histological examinations.Results Theλ⊥ of inj ured sciatic nerves in the proximal portion was slightly increased at 3 days and recovered to the normal at 2 weeks.Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were slightly raised at 1 day,reached to its maximum value at 3 days,and then decreased gradually after 1 week and dropped to the pre-operation level after 4 weeks.Theλ⊥ of inj ured sciatic nerves in the proximal portions was significantly higher than that of the sham-operated nerves from 1 day to 1 week(F=7.275,P=0.000). Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were significantly higher than that of the sham-operated nerves from 1 day to 3 weeks(F=5.851,F=3.794,P=0.001,P=0.000).However,there was no significantly difference between theλ∥ of inj ured nerves in each portion and sham-operated nerves .The negative correlation between theλ⊥ of inj ured sciatic nerves in the distal portion and the score of the nerve function in the injured limb was found (r=-0.938,r=-0.897,P<0.01).Conclu-sion Theλ⊥ of inj ured nerves in the traction portion and distal portion could monitor the process of degeneration and regeneration of sciatic nerve in traction inj ury,while theλ∥ plays no obvious role in diagnosis of nerve inj uries.

Objective To make sciatic nerve traction injury models of rabbit , in order to prospectively evaluate possibility and accuracy of diffusion tensor tracking (DTT) in sciatic nerve injures. Methods The right sciatic nerves of 32 New Zealand white rabbits were selected for traction injury , and the left sciatic nerves were the sham operation side. DTI scan was performed before and after the operation on 1st day , 3rd day, and 1 week, 2, 3, 4, 6 and 8th week respectively, and DTT was reconstructed. Then the length of reconstructed fiber tracts and fiber density index were calculated. After the MRI scan , the sciatic nerve was removed to perform pathologic examination at different time points. Results The difference of the length of reconstructed fiber tracts between nerve traction injury and sham operation side was significant at 1 day~2weeks after operation (P<0.05), while the difference was not significant at 3~8 weeks.The fiber density index of nerve traction injury and sham operation side was significantly different at 1 day~8 weeks(P<0.05). 1day after operation, myelin sheath of traction portion was obviously twisting. 3 days after operation , a large amount of myelin sheath broke down. 2 weeks after operation , axon, myelin sheath degeneration and regeneration coexisted at the same time. 8 weeks after operation , nerve fibers regenerated and restored to normal structure. Conclusion The length time curve and density index-time curve of nerve traction injury are consistent with the changes of pathology , which can be used as a supplementary method to evaluate the degeneration and regeneration in nerve injury.

Objective To investigate the effect of secondary transurethral electrocision for recurrent superficial bladder cancer.Methods One hundred and twenty patients with recurrent superficial bladder cancer were divided into experiment group and control group by random mechanical sampling method with 60 cases of each.Experiment group underwent secondary transurethral electrocision at 4 weeks after initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy,control group patients underwent initial transurethral electrocision and received mitomycin bladder perfusion chemotherapy.The two groups' follow-up cystoscopy at 3-month intervals,the follow-up time was 6-34 (18.6 ± 6.5) months,the recurrence was compared between each other.Results Within the follow-up period,the recurrence rate in experiment group was significantly lower than that in control group [21.7％(13/60) vs.63.3％(38/60),P＜0.01].Of all the recurrent patients,high grade rumor (G2 and G3 grade) was mainly,the recurrence rate of high grade tumor in experiment group was significantly lower than that in control group [26.2％ (11/42) vs.70.0％(35/50),P ＜ 0.01].Conclusions Secondary transurethral electrocision can reduce the recurrence rate of superficial bladder cancer (especially for the high grade tumor),it can exactly make the classification of malignant tumors and find residual tumor.So it is valuable in the clinical treatment.