ABSTRACT
A training cause for management of complex perineal tearing with bionic simulators were conducted from March 2018 to March 2019 among 223 midwives in Beijing Luohe Hospital affiliated to Capital Medical University and Shanghai First Maternal and Infant Health Hospital. The clinical comprehensive ability of normal delivery was assessed before and after training; and the effect of training with the complex perineal tearing simulator was evaluated after the training. There were significant differences in examination scores of theoretical knowledge and practical ability between senior (working years>5 year, n=85) and junior (working years 3-5 year, n=138) midwives both before and after training ( P<0.05); however the assessment results were all improved in both groups after training. All midwives gives high evaluation scores and feedback for the training of complex perineal tear with bionic simulator (5 points), indicating that the simulation training deserves promotion in clinical skill training for midwives.
ABSTRACT
Objective To investigate the relationship of programmed death ligand-1 (PD-L1) with clinicopathological characteristics,radiosensitivity and prognosis of the patients with esophageal squamous cell carcinoma(ESCC). Methods Ninety ESCC patients who received radical radiotherapy diagnosed by ESCC in Affiliated Hospital of North Sichuan Medical College were enrolled. Twenty cases of normal esophageal mucosa were used as the controls. The expression of PD-L1 was detected by using immunohistochemical SP method. Results The expression of PD-L1 protein was not correlated with age, gender, the maximum diameter of tumor, the length of lesion, the local aggressive of tumor, clinical stage and primary tumor volume (all P> 0.05). However, it was statistically correlated with the lymphatic metastasis (χ2= 4.404, P= 0.036). Meanwhile, PD-L1 positive expression was sensitive to radiation(χ2=4.888, P< 0.05). Single factor analysis showed that the maximum diameter of tumor and radiosensitivity were correlated with progression-free survival (PFS) (χ2=6.239,P =0.013;χ2=6.852,P =0.008; χ2= 6.312, P= 0.012) and overall survival (OS) (χ2=8.170, P = 0.004; χ 2= 4.261, P = 0.039; χ2= 5.003, P= 0.025) of ESCC patients. Multifactor analysis showed that the radiosensitivity and the maximum diameter of tumor affected PFS (OR= 0.512, 95 % CI 0.275-0.954, P= 0.035) and OS (OR= 0.507, 95 % CI 0.266-0.968, P= 0.039) in ESCC patients, respectively.Conclusions The level of PD-L1 expression is increased significantly in ESCC tissues compared with the normal esophageal mucosa tissues. PD-L1 may be a novel biomarker for predicting metastatic potential and radiosensitivity in ESCC patients, rather than the prognosis predictors of ESCC patients treated by radiotherapy.
ABSTRACT
Programmed death-1 (PD-1) occurs widely in a variety of human immune cells and tumor cells. When PD-1 is combined with programmed death-1 ligand (PD-L1), T-lymphocyte will be exhausted eventually resulting in tumor immune escape. Experiments in vitro and in vivo have demonstrated that inhibiting the binding of PD-1 with PD-L1, and blocking downstream signaling pathways can enhance endogenous anti-neoplastic immune effects. The expression of PD-1/PD-L1 is related to the clinical stage and prognosis of esophageal cancer patients, which may become the clinical biomarkers, serving as a new target for cancer immunotherapy.This paper reviews the relationship between PD-1/PD-L1 and esophageal cancer as well as the related treatment progress.