Activated leukocyte cell adhesion(ALCAM),also known as CD166/MEMD,is a transmembrane glycoprotein,which belongs to one of the members of the immunoglobulin superfamily and is one of cell adhesion molecules.In vivo,ALCAM is divided into three subtypes including membrane ALCAM,cytoplasmic ALCAM and soluble ALCAM,which mediate a variety of pathophysiological processes involved in the body by regulating cell-to-cell tropism or heterophonic adhesion.The abnormal expression of ALCAM is closely related to the invasion and metastasis of various tumor cells,and has a certain effect on the sensitivity of radiotherapy and chemotherapy.The article reviews the latest advances in ALCAM of gynecological malignancies.

‘University and college students' innovative ability training plan’ were launched from 2009 in Second Military Medical University. The innovative thinking and practical ability of students were improved by participation in research projects, writing scientific papers, academic exchanges and other activities. Students' innovative thinking, practice ability and cooperative spirit were promoted and unifica-tion of teaching and learning was achieved.

Objective: To study the anti hyperglycemic effect of rubusoside on diabetic rats induced by streptozotocin (STZ)and its mechanism . Methods: The STZ induced diabetic rats were dived into three groups and were given (ig.) saline, rubusoside and Phenformin respectively once a day. After three weeks, the levels of serum glucose, fructosamine, insulin,SOD were assayed. Results: Rubusoside could reduce the level of serum glucose significantly, enhance the ability of anti oxidation and stimulate the secretion of insulin in STZ induced diabetic rats. Conclusion: The action of rubusoside on secretion of insulin can be explained for the anti hyperglycemic effect.

Objective To investigate the impact of PET-CT on the target volume delineation and precise radiothera?py planning for patients with advanced non-small cell lung cancer (NSCLC). Methods PET-CT scanning was performed in 30 histologically proved NSCLC patients. The gross tumor volume (GTV) was delineated, and radiotherapy planning was es?tablished with identical parameters based on the CT image and PET-CT fused image, respectively. The differences of doses between GTV, planning target volume (PTV) and organsat rise (OAR) were compared. Results PET-CT image results changed the target volume delineation in 30 patients with 8 increased and 22 decreased. There were no differences in GTV and PTV between the VGTV and VPTV statistically, although PET-CT image changed conventional CT image size sketch of GTV and PTV. The V20 of total lung decreased in the PlanPET-CT compared with that of PlanCT (P<0.05), but no differences were found in the V30 of total lung, mean lung dose (MLD), the data of spinal cord, esophagus and heart. Conclusion PET-CT may reduce the radiation injuries in the lung and improve the target dose.

Objective: To observe the effect of ticagrelor for non-ST-segment elevation acute coronary syndrome after percutaneous coronary intervention (PCI). Methods: A total of 200 patients with non-ST-segment elevation acute coronary syndrome after PCI were enrolled in this study.And the patients were randomly divided into the observation group (18 months treatment group, 100 cases) and control group (12 months treatment group, 100 cases) according to the digital table.The control group was given dual antiplatelet therapy (DAPT) for 12 months, and then, suspended the usage of ticagrelor.The observation group was treated by DAPT for 18 months.The major adverse cardiovascular events (MACCE) and the secondary end point events were observed. Results: The incidence rate of MACCE between the two groups had no statistically significant difference (χ²=0.298, P=0.862). And there was no statisticallysignificant difference in the incidence of the secondary end point events between the two groups (χ²=1.963, P=0.375). Conclusion The usage of DAPT beyond or equal 12 months doesn't reduce the incidence of MACC and it will not increase the blooding rate.The use of DAPT (aspirin and ticagrelor) should be used less than 12 months.

OBJECTIVE: To investigate the pre-pregnancy body mass index(BMI), gestational weight gain(GWG)and gestational outcomes in women with high normotension during pregnancy. METHODS: The clinical data of 1500 pregnant women who recieved antenatal care and delivered in Songjiang District Maternal and Child Hospital, Shanghai from 2015 to 2017 were retrospectively analyzed. The women were divided into high normotension group, normotension group and hypertensive disorder of pregnancy (HDP) group with 500 cases in each group. The general information, pre-pregnancy body mass index, gestational weight gain and gestational outcomes were analyzed. RESULTS: There were significant differences in pre-pregnancy BMI and GWG between the high normotension group and the normotension group (all <0.017), and there was significant difference in pre-pregnancy BMI between the high normotension group and HDP group (<0.017). In terms of adverse pregnancy outcomes, the incidence of oligohydramnios, placental abruption, postpartum hemorrhage, fetal distress and small for gestational age infant were higher in the high normotension group than those in the normotension group, but the differences were not of statistical significance (all >0.017); the incidence of oligohydramnios, placental abruption, cesarean section, postpartum hemorrhage, premature delivery and small for gestational age infant in HDP group were higher than those in high normotension group (all <0.01). In high normotension women with adverse gestational outcomes, the proportion of low GWG or too much GWG was higher and the proportion of normal GWG was lower than those in high normotension women without adverse gestational outcomes (all <0.01). CONCLUSIONS Pre-pregnancy BMI and GWG are correlated with pregnancy blood pressure and gestational outcomes. Reasonable intervention to gestational weight gain of pregnant women with high normotension is of significance to improve the gestational outcomes.
Blood Pressure ; Body Weight ; Cesarean Section ; Child ; China ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

Objective To explore the diagnostic value of endobronchial ultrasound?guided transbronchial needle aspiration ( EBUS?TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS?TBNA. Methods A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS?TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92. 9%, 100%, 100% and 25. 0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate ( 97. 7%) , followed by the paratracheal lymph nodes ( 91. 2%) , with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%,) showed no significant difference ( P=0. 065 ) . The positive rate of EBUS?TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions EBUS?TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS?TBNA examination will be further improved.

Objective To explore the diagnostic value of endobronchial ultrasound?guided transbronchial needle aspiration ( EBUS?TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS?TBNA. Methods A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS?TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92. 9%, 100%, 100% and 25. 0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate ( 97. 7%) , followed by the paratracheal lymph nodes ( 91. 2%) , with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%,) showed no significant difference ( P=0. 065 ) . The positive rate of EBUS?TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions EBUS?TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS?TBNA examination will be further improved.

Multiple primary lung cancer(MPLC)refers to patients with two or more primary lesions of lung cancer.It can be divided into synchronous MPLC(sMPLC)and metachronous MPLC(mMPLC)based on the timing of occurrence.In recent years,the detection rate of MPLC has gradually increased.However,considerable controversy exists in distinguishing MPLC from intrapulmonary metastasis(IM),especially when the histopathological types are identical.Given the significant differences in treatment strategies and prognosis in clinical practice currently,accurate diagnosis of MPLC is cru-cial for personalized precision therapy.Molecular genetics and sequencing technologies offer effective strategies for assessing the clonal origin of tumors.There have been reports of coexisting mutations in the epidermal growth factor receptor(EGFR)and anaplastic lymphoma kinase(ALK)fusion genes in non-small cell lung cancer,but case of EGFR mutation following an ALK mutation has not been mentioned.This article accurately diagnoses and retrospectively analyzes the clinical data of a case of ALK mutant adenocarcinoma in a male patient who developed an EGFR mutation with multiple metastases four years after surgery,and reviews the relevant literature.This paper aims to deepen the understanding of mMPLC and provide clinical refer-ences for the diagnosis and treatment of such patients.

Objective:To investigate the clinical effect of early bronchoalveolar lavage on patients with aspiration pneumonia.Methods:A retrospective study was conducted on 55 patients with aspiration pneumonia who met inclusion criteria but not exclusion criteria in the Intensive Care Department of our hospital from January 2020 to April 2021. The patients were divided into the control group (32 cases) and the bronchoscopic lavage group (23 cases) according to whether they received bronchoscopic lavage within 24 h after aspiration. Basic information (sex, age, body mass index, chest X-ray score, oxidation index, temperature, heart rate, respiratory rate, white blood cells, PCT, IL-6, CPR and APACHE Ⅱ score), etiology changes at the early stage (≤ 3 d) and later stage (4-7 d after admission), and changes in prognostic indexes (mechanical ventilation time, length of ICU stay, length of stay and mortality) were compared between the two groups. The clinical efficacy of early endoscopy lavage for aspiration pneumonia was evaluated.Results:The positive rate of early etiological culture was 85.2%, the bacterial positive rate was 72.9% and the fungal positive rate was 14.6%. Pseudomonas aeruginosa accounted for 20.8%, Klebsiella pneumoniae accounted for 14.6%, Staphylococcus aureus and Streptococcus accounted for 12.5%, and there was no significant difference in the distribution between the bronchoscopic lavage group and the control group (all P>0.05). The positive rate of late etiological culture was 88.6%, the bacterial positive rate was 85.7% and the fungal positive rate was 2.9%. The positive rate of late bacterial culture was significantly decreased in the bronchoscopic lavage group ( P < 0.05), and the other results were not significantly different from the control group (all P>0.05). After early bronchoscopic lavage, the duration of mechanical ventilation, length of ICU stay and length of stay were significantly shortened, and the fifth day CPIS score was significantly decreased (all P< 0.05). Conclusions:Early endotracheal lavage can reduce mechanical ventilation time, length of ICU stay and length of stay of aspiration pneumonia, and reduce the positive rate of bacterial culture in the lung at the later stage, which needs to be further verified by a large randomized controlled study.