Objective The aim of this study was to investigate the diagnostic value of the intravoxel incoherent motion (IVIM) for discriminating nonmetastatic from metastatic mediastinal lymph nodes in lung cancer.Methods IVIM was performed preoperatively on 66 patients with lung cancer during October 2015 to June 2016 in Capital Medical University Affiliated Beijing Chaoyang Hospital.Preoperative examination including the chest MRI scan,chest CT,head MRI,bone scan-ning and the cardiopulmonary function.None of the patients was undergone any kind of treatment about the cancer before the examinations,the neoadjuvant chemotherapy or radiation therapy,immunotherapy and gene targeted therapy were included.Measured the short axis diameter and the IVIM parameters of the mediastinal lymph nodes,apparent diffusion coefficient(ADC),diffusion coefficient(D),pseudo-diffusion coefficient(D *),and perfusion fraction(f).All the patients underwent the lobectomy or wedge resection and lymph node dissection or systematic sampling.By comparing the IVIM parameters of the nonmetastatic and metastatic mediastinal lymph nodes according to the pathological examination,draw the ROC curves to find the best cutoff value for diagnosis.And 42 cases were used to comparing the value of the MRI and CT in differential diagnosis.Results MRI measured 184 groups mediastinal lymph nodes,including 164 groups without metastasis,20 groups with metastasis.The ADC,D,D *,f values and short axis diameter of the nonmetastatic lymph nodes(n =164) were(2.880 ± 0.785) × 10-3 mm2/s,(0.670 ± 0.179) × 10-3 mm2/s,(0.383 ± 0.123) × 10-3 mm2/s,0.422 ± 0.119,(6.546 ± 1.932) mm,respectively,and (1.897 ±0.657) × 10-3 mm2/s,(0.472 ±0.210) × 10-3 mm2/s,(0.354 ±0.130) × 10-3 mm2/s,0.412 ±0.090,(7.510 ± 2.773) mm respectively for the metastatic lymph nodes (n =20).The ADC and D value of the nonmetastatic lymph nodes were significantly higher than the metastatic lymph nodes(P ＜0.01).While the other paraneters(D *,f,and short axis diameter) between the two groups did not show significantly different.Optimal cutoff values(area under the curve,sensitivity,and specificity) for distinguishing metastatic from nonmetastatic lymph nodes were as follows:ADC =1.890 × 10-3 mm2/s (0.871,92.7％,80.0％);and D =0.648 × 10-3mm2/s(0.740,70.0％,84.1％).Conclusion IVIM is useful to distinguish metastatic from nonmetastatic lymph nodes in lung cancer.The ADC and the D values are significant higher in metastatic lymph nodes,which more sensitive than the other parameters(D *,f,and short axis diameter).As a result,IVIM can be used in the N-stage diagnosis of lung cancer.

A growing body of evidence has indicated the important role of autophagy receptors in directing ubiquitinated or non-ubiquitinated cargos towards autophagy. Autophagy receptors bind to LC3 (microtubule-associated protein 1 light chain 3) on phagophore and autophagosome membranes, and recognize signals on cargoes in the delivery system of autophagy. However, the diverse domains in the receptor structures determine that their roles would never be limited to autophagy. Up to date, increasing numbers of the receptor proteins have been demonstrated to serve as a molecular link or switch participating in autophagic degradation, apoptosis or cell survival signals. Here, we highlight the non-autophagic roles of these receptor proteins to draw attention to this growing research topic.
Apoptosis ; Autophagy ; Humans ; Microtubule-Associated Proteins ; physiology ; Signal Transduction ; Ubiquitination

Adult ; Calmodulin-Binding Proteins ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Leiomyoma ; metabolism ; pathology ; surgery ; Leiomyosarcoma ; pathology ; Spinal Canal ; Spinal Neoplasms ; metabolism ; pathology ; surgery ; Young Adult

A satisfaction survey carried out by Beijing Chao-Yang Hospital during the Beijing 2008 Olympic Games, found differences of patient satisfaction between locals and overseas patients in consulting environment, outpatient procedure, quality of service, quality of diagnosis and treatment. The patient satisfaction of overseas patients was lower than locals. Especially noteworthy is the low satisfaction of the former for the hospital coloring, privacy in the sector, registration, vocal communication, patient condition statement, nurse attitude and service quality. Real-time improvement in these aspects of medical services has harvested obvious progress. Results of the satisfaction survey provided valuable reference materials for large-scale activities, and ongoing improvement of medical services in the long run.

Objective To evaluate the impact of comorbidity and age on the tolerance of firstline single-agent chemotherapy in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods Clinical data of 61 elderly patients with advanced NSCLC(aged over 70 years,median age 72 years) receiving first-line single agent chemotherapy were retrospectively analyzed in this study.Performance status(PS) between 0-1 score was in 52 patients,PS 2 score in the other 9 patents.Patients were treated with gemcitabine or docitaxel as the first line chemotherapy,and the median number of chemotherapy cycles was 3.4.Comorbidity was assessed by Charlson comorbidity index (CC1).Patients with CCI equal to 0 were classified as non comorbidity group(n=26),and patients with CCI≥1 were classified as comorbidity group(n=35).Adverse reactions were graded by using the criteria of NCI-CTC v3.0.Results Age and PS could not predict adverse effects of grade 3 or 4.The incidence of hematologic toxicity of grade 3 or 4 was higher in comorbidity group than in noncomorbidity group(40.0％ vs.15.4％,x2 =4.36,P=0.037).The incidences of febrile neutropenia,non hematologic toxicity of grade 3 or 4 and treatment suspension were higher in comorbidity group than in non-comorbidity group.The most common types of comorbidity were diabetes and chronic pulmonary disease.The incidence of non-hematologic toxicity of grade 3 or 4 was increased in patients with chronic pulmonary disease as compared with patients without chronic pulmonary disease(41.4 ％vs.11.5％,x2=6.061,P=0.032).Conclusions The incidences of adverse reactions,especially hematologic toxicity of grade 3 or 4 are significantly increased in patients with comorbidity after singleagent chemotherapy.Evaluation of comorbidity before treatment is helpful to predict the tolerance of single-agent chemotherapy in elderly NSCLC patients.

Objective To investigate the expressions of estrogen receptor (ER) and progesterone receptor (PR) in different tumor tissues of invasive ductal carcinoma(IDC) of the breast. Methods A total of 32 cases of IDC samples were collected. ER and PR expressions in 4 different sites of every sample were measured by immunohistochemical(IHC) assays. Results Overall, a high concordance in both estrogen receptor and progesterone receptor expressions are observed between different tumor tissue sites. The best Kappa values were 0.789 and 0.810 for ER and PR expression respectively. The worst Kappa values were 0. 563 and 0.672,respectively. Conclusion ER and PR expression is not significantly different in different tumor tissues of the same IDC sample. Repeated testing in different tumor tissue sites has little contributions in clinical settings.

BACKGROUND:Both local infiltration analgesia and femoral nerve block are used for the pain management after total knee arthroplasty. Controversy stil remains regarding the optimal technique for pain relief. OBJECTIVE:To systematical y evaluate analgesic effects of local infiltration analgesia and femoral nerve block after total knee arthroplasty. METHODS:Databases including PubMed, EMBASE, the Cochrane Library, Web of Science and CBM, were comprehensively searched to identify randomized control ed studies comparing local infiltration analgesia with femoral nerve block. Two reviewers independently selected trials, included literatures, extracted data, and assessed the methodological qualities of included studies according to Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. When there were different opinions, it was decided by the third author. Data were analyzed by RevMan 5.3 software. RESULTS AND CONCLUSION:(1) Eleven randomized control ed trials involving 566 patients were included. (2) At 24 and 48 hours (h) after surgery, there were no significant differences between the local infiltration analgesia and femoral nerve block groups, in Visual Analog Scale scores [MD24 h=0.15, 95%CI (-0.26, 1.28), P>0.05;MD48 h=0.19, 95%CI (-0.06, 0.44), P>0.05] in the resting state, and [MD24 h=-0.01, 95%CI (-0.51, 0.48), P>0.05;MD48h=0.18, 95%CI (-0.45, 0.82), P>0.05] in the active state, amount of analgesic drug use [MD24 h=-2.23, 95%CI (-5.63, 1.16), P>0.05;MD48 h=2.44, 95%CI (-1.08, 5.95), P>0.05], hospital stay [MD=0.05, 95%CI (-0.40, 0.50), P>0.05], postoperative nausea and vomiting [OR=1.09, 95%CI (0.39, 3.04), P>0.05] and postoperative infection [OR=0.99, 95%CI (0.44, 2.59), P>0.05]. (3) These results indicated that the analgesic effect of local infiltration analgesia was identical to that of femoral nerve block after total knee arthroplasty. Due to its simple operation, local infiltration analgesia can be used as a standard analgesia method after total knee arthroplasty.

Objective To evaluate CT in the diagnosis of small bowel obstruction in children. Methods Thirty one cases with small bowel obstruction manifestations on CT and plain radiograph were analysed. The age ranged from 9 months to 14 years, male 17 cases, female 14 cases. There were 29 acute small bowel obstructions, and 2 chronic obstruction. Seven cases had history of previous abdominal operation. Results Corred diagnosis was made in 19 cases and 29 cases respectively by plain film and CT. The accurate etiologic diagnosis could be made by CT in 18 cases, including small bowell stone 4 cases, intussusception, 5 localized infection and adhesion 6 intraluminal bowel duplication, 1 congenital umbilical hernia, congenital malrotation of the intestine 1 case.Combined with history of abdominal operation the accurate CT etiologic diagnosis increased to 25 cases.There were 4 CT false negative cases and 2 plain film false negative cases. Conclusion The CT is obviously superior to plain radiograph in detecting strangulation and gas in bowel wall,better dilineating the transitional segment of bowel stenosis thereby demonstrating the case of obstruction which is very helpful for clinical management.

Objective To understand the relationship between Toxoplasma gondii infection and pet-breeding and hygienic status. Methods One or two districts were chosen from Jining City, Za-ozhuang City and Linyi City as study areas and the questionnaire surveys were carried out for hygienic status, etc. The pet-breeders and non-pet-breeders were paired by sex, age, living place and occupation so on in a ratio of one to one. Blood samples taken from each were tested for antibodies against T. gondii with ELISA in a double-blind method. Results The total infection rate was 14. 25%, much higher than that investigated ten years ago (1. 53%). The mean positive infection rate was 19.91% in the pet-breeding groups and 8.60% in the control groups (x2 = 11.57, P

Objective To evaluate the dynamic contrast-enhanced magnetic resonance angiography(DCE MRA)value of definitive diagnosis and typing as well as its roles to clinical management with aortic dissection(AD).Methods 20 patients with different types aortic dissection were examined using DCE MRA and proved by operation.Results The reliable MRA image was obtained in all the 20 cases.The MRA typical appearences were the true and false lumen of AD.The entrance and exit site,true and false channel,and intimal flap can be demonstrated on DCE MRA image.Conclusion DCE MRA is an accurate,quick,non-invasive medical imaging technique and can serve as an initial imaging modality for AD diagnosis.