Purpose To analyze the 18F-FDG PET/CT features of small intestinal malignant neoplasm, and to discuss the diagnosis value. Materials and Methods Forty-seven patients who were highly suspected with small intestinal tumors underwent 18F-FDG PET/CT whole body scan were retrospectively analyzed, the results of PET/CT examinations and the findings of biopsy and surgical pathology were compared. The maximum of intestinal wall thickness (IWTmax) and maximum of standardized uptake value (SUVmax) were calculated to analyze the relationship of them under different pathological conditions. Results Six out of the 47 small intestinal tumors were benign, the other 41 were malignant tumors among which 19 were malignant lymphoma and 17 were adenocarcinoma. The sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value of 18F-FDG PET/CT in the diagnosis of small intestinal malignant neoplasm were 92.7%, 83.3%, 91.5%, 97.4% and 62.5%, respectively. Compared with those of benign tumors, the SUVmax and IWTmax of malignant intestinal tumors were significantly higher (t=5.596 and 2.376, P<0.05). The SUVmax in small bowel adenocarcinoma was significantly lower than that in malignant lymphoma (t=2.419, P<0.05);the IWTmax. between the two kinds of tumors showed no difference (t=0.369, P>0.05). The SUVmax and IWTmax of small intestinal malignant lymphoma had no correlation (r=0.293, P>0.05), whilst there was significant correlation between the IWTmax and SUVmax in small intestinal adenocarcinoma (r=0.542, P<0.05). Conclusion The SUVmax and IWTmax of malignant intestinal tumors are higher than those of benign intestinal tumors; 18F-FDG PET/CT imaging is rather reliable in differentiating small intestinal malignant tumors from benign ones. Intestinal malignant lymphoma shows a higher uptake of 18F-FDG than intestinal adencarcinoma, but the intestinal wall thickness of the two kinds shows no difference.

Although the interventional radiology, a rapidly expanding medical specialty, has already been widely popularized and generally accepted for many years, it is still facing lots of challenges and turf wars, such as the brain drain, understaffed and the gap between the old and the young. This article attempts to analyze the reasons through investigating the current teaching situation of interventional radiology in medical coUeges and finding out the undergraduates' attitude to interventional radiology, in order to explore possible paths for solving the imbalance between supply and demand of qualified personnel.

Objective:To reveal the behavior characteristics of health delivery system(HDS) and the dynamical mechanism by which HDS promoting population health,so as to provide theoretical and methodological evidences for the decision-making of national macro health system.Methods: The macro model of HDS was constructed by using the theory of complex system and the method of system dynamics.Results: The principle of "high coverage and reasonable quality" was put forward as developmental strategy of national health service.The improvement of population health was taken as the system objective of HDS;meanwhile,HDS was community-centered and city-country integrative.The macro model of HDS was constructed based on the above objectives.Conclusion: Modeling based on system dynamics is effective to reveal the complexity of health delivery system.The HDS complex system model constructed in this article can be used to analyze and interpret the behavior characteristics of HDS and the dynamic mechanism by which HDS promoting population health.

Although the interventional radiology, a rapidly expanding medical specialty, has already been widely popularized and generally accepted for many years, it is still facing lots of challenges and turf wars, such as the brain drain, understaffed and the gap between the old and the young.This article attempts to analyze the reasons through investigating the current teaching situation of interventional radiology in medical colleges and finding out the undergraduates' attitude to interventional radiology, in order to explore possible paths for solving the imbalance between supply and demand of qualified personnel.

Objective To evaluate the imaging characteristics of 18 F-FDG PET/CT in patients with Castleman's disease (CD).Methods Twelve patients (male 7,female 5,mean age:(51.2±19.3)years) with pathologically confirmed CD and 18F-FDG PET/CT were retrospectively enrolled.A lesion with SUVmax greater than that of normal liver tissue was defined as positive.Lesion size (short diameter) was measured.Correlation between size and SUVmax was analyzed by Pearson correlation analysis.SUVmax of different clinical and pathological types was compared using Mann-Whitney rank sum test.Results Among 12patients,7 patients had localized CD (LCD) involving a single group of lymph nodes and 5 patients had multicentric CD (MCD) involving more than one group of lymph nodes with some having lung and spleen infiltration.A total of 129 positive lesions were found (7 of LCD,122 of MCD) and the average SUVmax was 4.20±1.84 (range:2.50 to 10.70).There was no significant correlation between SUVmax and lesion size (r =0.189,P＞0.05).There was no significant difference in SUVmax between LCD and MCD (4.23±1.77 vs 4.19±1.86; Z=-0.108,P＞0.05) ; but there was significant difference in SUVmax between the patients with and without clinical manifestations (4.56±2.06 vs 3.41±0.87; Z=-2.443,P＜0.05).No significant difference was found between SUVmax of hyaline vascular CD and plasma cell CD (3.63±0.89 vs 4.26±1.91; Z=-0.519,P＞0.05).Conclusions CD shows primarily lymph node involvement with increased 18F-FDG uptake.However,the degree of FDG uptake does not correlate with clinical presentation or pathological types.

Objective To investigate the relationship between metabolic parameters of 18F-FDG PET-CT and cilinicopathological features of patients with lung squamous cell carcinoma. Methods The study comprised 118 patients with lung squamous cell carcinoma. All patients undergone 18F-FDG PET-CT before surgery. Maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) were measured, and total lesion glycolysis (TLG) was calculated. Relationship between metabolic parameters and clinicopathological factors was analyzed. Results SUVmax, MTV and TLG of 118 primary lesions were 11.93 (3.12-41.46), 27.71 cm3 (0.54-347.10 cm3) and 153.13 (1.65-2219.37), respectively. SUVmax was related to tumor differentiation degree and pleural invasion (χ2= 15.358, P= 0.000; Z= -2.875, P= 0.004); MTV was related to tumor differentiation degree, pleural invasion, vascular invasion and lymphatic metastasis (χ2= 13.341, P= 0.001; Z= -2.855, P= 0.004; Z= -2.683, P= 0.008; Z= -3.951, P= 0.000), TLG was also related to these clinicopathological factors (χ2= 15.609, P= 0.001;Z= -3.901, P= 0.002;Z= -2.311, P=0.021;Z= -3.721, P= 0.000). T stage and TNM stage had positive correlation with all metabolic parameters (r= 0.326, 0.794, 0.732;r= 0.358, 0.718, 0.668; all P< 0.05). And for N stage, SUVmax was no correlative (r=0.125, P=0.107), but MTV and TLG were positively correlative (r=0.399, 0.371, both P< 0.05). According the MTV or TLG and tumor size, patiens were divided into three groups: low-risk group, moderate-risk group and high-risk group. Significant differences were found among the three groups not even in MTV model, but also in TLG model (χ2= 20.800, P= 0.000; χ2= 20.069, P= 0.000). Conclusions Metabolic parameters of lung squamous cell carcinoma primary lesion have good correlation with clinicopathological factors, and can reflect partial characteristics of the tumor pathology in a certain extent. Furthermore, the probability of lymphatic metastasis could be predicted by MTV or TLG combined with tumor size.

Objective To investigate the potential factors which have impact on the working space for surgeons in gasless laparoscopic cholecystectomy and to probe into the specifications of gasless surgeries.Methods Clinical data of 49 cases of gasless laparoscopic cholecystectomy between March 2007 and July 2010 were summarized.The impacts of body mass index,bowel preparation and means of anesthesia on operation time and conversion to laparotomy were analyzed.Results For patients with body mass index ≤25and ＞ 25,operation times were (43.0 ± 5.4) min,and (52.8 ± 7.4 ) min,respectively,and rates of conversion to laparotomy were 0/34 and 4/15,respectively.Both indices in the first group were higher.For patients with and without bowel preparation,operation times were (44.5 ± 5.4) min and (46.1 ± 8.0)min,respectively,and rates of conversion to laparotomy were 2/26 and 2/23,respectively.For patients with epidural anesthesia and lumbar/epidural anesthesia,operation times were (46.5 ± 7.9) min and (44.1 ±6.8) min,respectively,and rates of conversion to laparotomy were 2/24 and 2/25,respectively.Conclusions The operation time of gasless laparoscopic cholecystectomy could be affected by many factors,such as body mass index.Gasless operations can be improved by evaluating the conditions of patients correctly and by selecting suitable operation methods,anesthesia means and bowel preparation.

Objective To investigate the predictive value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) calculated from 18F-FDG PET-CT results for postoperative recurrence and prognosis in patients with resectable pancreatic cancer. Methods From may 2009 to December 2015, 30 patients with pancreatic cancer who underwent curative resection after PET-CT examination were enrolled, and the clinic pathological data and 18F-FDG PET-CT data were retrospectively analyzed. The prognostic value of SUVmax, SUVmean, MTV, TLG and other prognosis factors were analyzed. Results In 30 patients with pancreatic cancer, preoperative 18F-FDG PET-CT detected all primary lesion (10 0%). 29 patients were recurrence or metastasis, and 26 patients were died with median of 17.8 months (2.6-39.6 months) follow-up. The median progression-free survival (PFS) time was 6.5 months and the median overall survival (OS) time was 11.6 months. The multivariate analysis revealed the histological differentiation and MTV were the independent influencing factors for PFS (both P<0.05). The lymph node metastasis, MTV and TLG were the independent influencing factors for OS (all P<0.05). Conclusion The MTV and TLG of PET-CT may be predicting the recurrence and survival of patients with pancreatic cancer after curative resection, suggesting that it can be used to guide the individual treatment.

Objective Discuss the interference of injection cefotiam on vanadate oxidation method and dry chemical method assay total bilirubin .Methods Collected 60 examples ,include total bilirubin concentration 20 examples less than 20 μmol/L ,20 examples between 150-220 μmol/L and 20 examples between 350-410 μmol/L ,add an equal volume of various concentrations of cefotiam in each case ,formulated into cefotiam final concentrations of 300 ,150 ,75 mg/L of serum samples as the test group ,add an equal volume of water in each serum samples as the control group ,determine all the samples total bilirubin concentration respectively by vanadate oxidation method and dry chemical method ,compared the interference of cefotiam on determined total bilirubin by two method ,analyze the data by SPSS13 .0 .Results Determined total bilirubin by dry chemical method ,the test group higher than the control group ,the difference was statistically significant(P<0 .05) ,at the same total bilirubin levels ,with cefotiam concentrations decreased ,increased rate of total bilirubin concentration were decreased in the experimental group .Determined total bilirubin by vanadate oxidation method ,when the total bilirubin concentration between 150 -220 μmol/L ,the test group was higher than the control group ,the difference was statistically significant(P<0 .05) .Conclusion Interference of injection cefotiam on determined to‐tal bilirubin by dry chemical method is strong ,and with the drug concentration increased ,effect is more obvious ,but determination of total bilirubin by vanadate oxidation method has almost no effect .