Objective To investigate the clinical significance of PET-CT to diagnose breast cancer and the axiUary lymph nodes metastasis. Methods 40 patients with breast cancer performed PET-CT were enrolled in the research. Qualitation the primary tumor and accuracy of PET-CT were evaluated on pathological results and compared with axillary lymph nodes dissection. To analyzed the concordance of the size of primary tumor on pathological result with B-mode ultrasonic and PET-CT and the correlation with the SUV. Results The accuracy, sensitivity and specificity of PET-CT in identifying breast cancer were 95%, 94%, 100%. The accuracy, sensitivity and specificity of PET-CT based on the situation of the axillary lymph node dissection were 88.2% 89.2% 83.3%. A significant association was found between tumor weiweihong and PET-CT, furthermore it had not association with SUV. Conclusion The diagnosis of PET-CT in identifying breast cancer and the axillary lymph node metastasis basically conforms to pathology. It possesses high sensitivity and specificity especially in identifying the size of the primary lesion. It offers a beneficial method to determine the axillary lymph node dissection and reasonable therapeutic regimen.

Objective To evaluate the role of μ opioid receptor exon 7 in the analgesic efficacy of endomorphin-2 in rats.Methods Twenty-four male Sprague-Dawley rats in which IT catheters were successfully implanted,weighing 220-260 g,were randomly divided into 3 groups (n =8 each) using a random number table:normal saline control group (group C),negative siRNA control group (group N-siRNA) andμ opioid receptor exon 7 siRNA group (group E7-siRNA).In C,N-siRNA and E7-siRNA groups,30μl saline solution,negative siRNA plasmid 20 μl + lipofectamine 2000 (10 μl),and μ opioid receptor siRNA plasmid 20μ1 + lipofectamine 2000 (10 μl) were intrathecally injected once a day for 3 consecutive days.The mechanical pain threshold was measured on 4th day (baseline).Endomorphin-2 10 μg was injected intrathecally at 1 h after measurement of the pain threshold.The mechanical pain threshold was measured at 5,20,40 and 60 min after endomorphin-2 injection,and the analgesic efficacy was calculated.Results There was no significant difference in the baseline pain threshold among the three groups.Compared with group C,no significant difference was found in the analgesic efficacy at each time point after endomorphin-2 injection in group N-siRNA,and the analgesic efficacy was significantly decreased at 5 and 20 min after endomorphin-2 injection in group E7-siRNA.Conclusion μ opioid receptor exon 7 is involved in the analgesic efficacy of endomorphin-2 in rats.

Objective To evaluate the safety and efficacy of radical antithrombotic therapy(aspirin,clopidogrel and tirofiban) in the treatment of senile (≥ 75 years) non-ST-elevation acute coronary syndrome (NSTEACS).Methods A total of 146 senile patients with NSTEACS were divided into observation group (70 cases) and control group(76 cases) by random digits table method.The control group was given aspirin,low molecular weight heparin and clopidogrel,and the observation group was added tirofiban (intravenous loading dosage:0.4 μ g/ (kg· min) for 30 min and then maintaining 0.1 μ g/ (kg· min) for 48-72 h).The occurrence of major adverse cardiovascular events (MACE) within 30 d after treatment,7 d angina pectoris control rate and adverse reactions were observed in two groups.Results The occurrence rate of MACE within 30 d after treatment was 5.7％ (4/70) in observation group,and 14.5％ (11/76) in control group,and there was significant difference (P ＜ 0.05).The 7 d angina pectoris control rate was 92.9％ (65/70) and 76.3 ％ (58/76) in observation group and control group,and there was significant difference (P ＜ 0.05).The incidence of bleeding was 10.0 ％ (7/70) and 7.9 ％ (6/76) in observation group and control group,and there was no significant difference (P ＞ 0.05).There were no major bleeding events in two groups.One case had thrombocytopenia in observation group,but there was no significant difference compared with that in control group(P ＞ 0.05).Conclusion Triofiban on the basis of aspirin and clopidogrel in the treatment of senile NSTEACS is effective and safe.

Objective To investigate the diagnostic value of 18F-FDG PET and 99Tcm-MDP imaging in detection bone metastases. Methods 93 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. The results of the 2 different modalities were analyzed. Results Of the 93 patients, 64 patients were found to have bone metastases by PET and MDP imaging. Among the 64 patients, 43 patients were found both positive PET and MDP. 16 patients had positive PET whereas negative MDP. 5 patients had negative PET whereas positive MDP. The sensitivity, specificity and accuracy of 18F-FDG PET and 99Tcm-MDP imaging were 92.2 %, 75.0 %(P 0.05), 92.5 %,76.3 %(P

Objective To explore the reasons for disharmony between medical staff and medical staff because of electronic clinical ordering,to specificate electronic medical order in ward in order to create a harmonious relationship between doctors and nurses. Methods The methods of qualitative research conducted in-depth interviews of 12 medical staff, field recordings and transcripts, and the method of content analysis were used. Results Two themes were sublimated:medical staff reasons:lack of communication between the medical staff;new doctors didn't have a good command of medical norms of specialist electronic orders; on the responsibility of checking the doctor's advice problems may lead to potential adverse events occurrence. System equipment reason: the electronic doctor's advice system set up the problem; the office computer quantity is insufficient. Conclusions Nonstandard electronic medical management leads to the disharmony of health care. It is suggested to standardize the management of electronic medical advice by implementation of the responsibility to avoid medical coupling errors. The health care workers need to strengthen communication, mutual understanding and forgiveness, in order to create a harmonious medical environment.

Objective To evaluate the role of the complement 1 q (C1 q) in hepatic ischemia-reperfusion (I/R) injury in rats.Methods Sixty healthy male Sprague-Dawley rats,aged 3-4 months,weighing 180-200 g,were randomized into 2 groups:sham operation group (S group,n =12) and hepatic I/R group (I/R group,n =48).Hepatic specimens were obtained at 1,3,6 and 24 h of reperfusion and were then cut and stained with haematoxylin and eosin for examination of histological changes of the liver (with light microscope) and for determination of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content (by colorimetric method),expression of Clq mRNA (using real-time PCR) and expression of Clq (by using Western blot).Results Compared with S group,the activity of SOD was gradually decreased,the content of MDA was gradually increased,and the expression of Clq and Clq mRNA was gradually up-regulated and peaked at 3 h of reperfusion with the prolongation of reperfusion time in I/R group (P ＜ 0.05).The pathological changes of the liver were aggravated with the prolongation of reperfusion time in I/R group.Conclusion Activation of C1 q is involved in hepatic I/R injury in rats.

Aim To investigate the inhibitory effects and mechanism of action of isoliensinine (IL) on the proliferation of porcine coronary arterial smooth muscle cells (CASMCs) induced by phenylephrine (Phen) and its mechanisms of action. Methods MTT assay, immunohistochemical method and Western blotting were adopted. Results IL (0.03-3 μmol·L-1) could inhibit the CASMCs proliferation induced by Phen (0.1 μmol·L-1) in a concentration-dependent manner. IL (0.1 μmol·L-1) antagonized Phen-induced overexpression of PDGF-β and bFGF from 0.545±0.026 and 0.47±0.03 to 0.458±0.019 and 0.376±0.017 (P<0.01, P<0.01). IL (0.1 μmol·L-1) also decreased c-fos, c-myc and hsp70 overexpression induced by Phen from 0.57±0.04, 0.44±0.04 and (173±36)% to 0.46±0.05, 0.372±0.021 and (115±35)% respectively (P<0.01, P<0.01, P<0.01). Conclusion IL exerted antiproliferative effect on CASMCs induced by phenylephrine, and its mechanisms were related to decrease the overexpression of growth factors (PDGF-β, bFGF), protooncogene (c-fos, c-myc) and hsp70.

Objective To investigate the value of integrated PET-CT with 18F-FDG in the diagnosis of non-small cell lung cancer.Methods 91 patients with non-small-cell lung cancer(NSCLC)and 10patients with benign disease underwent integrated PET-CT from February 2004 to May 2005.Other diagnostic procedures were analysed. Results 91 patients with lung cancer were found by positive SUV and pathologically confirmed.Of the 10 patients with benign disease.positive SUV were found in 3 cases.2 cases with tuberculosis and 1 case with inflammatory pseudotumor were confirmed.Negative SUV were found in 7cases.1 case was incorrectly diagnosed by integrated PET-CT.The sensitivity,specificity and accuracy of integrated PET-CT in the diagnosis of NSCLC were 100%,90%,99%,respectively.Forty-eight of 91patients with lung cancer underwent operation.There were 30 cases with and 18 cases without mediastinal nodal metastases.There were two false negative cases and one false positive case.The sensitivity,specificity and accuracy of integrated PET-CT in the diagnosis mediastinal nodal metastases were 93.3%,94.4%,93.8%.respectively.Metastases were identified in 33 cases.Conclusion Functional metabolism and anatomy imaging are fused in integrated PET-CT.The primary site and metastases lesion are correctly diagnosed by integrated PET-CT.The accuracy of integrated PET-CT in the diagnosis of NSCLC is over 90%.

Objective To investigate the effect of different doses of dexmedetomidine (DEX) on myocardial ischemia-reperfusion injury (MIRI) in rats.Methods Seventy-five SD male rats weighing between 250 and 300g were divided into sham group,MIRI group,small-dose DEX group,medium-dose DEX group and high-dose group according to the random number table,with 15 rats per group.Threading the left anterior descending coronary artery was done only in sham group,but the MIRI model was produced in the rest groups by ligation of the artery for 30 minutes followed by 120 minutes of reperfusion.Fifteen minutes before the ligation,small-,medium-and high-dose DEX groups were injected 2.5,5 and 10 μg · kg-1 · h-1 of DEX respectively until the end of reperfusion.Instead,an equal volume of normal saline was given in sham and MIRI groups.At the end of reperfusion,five rats in each group were used to determine the myocardial infarct size,and arterial blood samples and myocardial tissues from ten rats in each group were used to measure serum levels of interleukin-1β (IL-β) and serum tumor necrosis factor-α (TNF-α),expression of myocardial nuclear factor kappa B p65 (NF-κB p65) and change of myocardial pathomorphology.Results Myocardial infract size,degree of myocardial pathomorphology structure damage,serum levels of IL-1 β and TNF-αt and expression of myocardial NF-κB p65 in sham group were significantly lower in sham group than other groups (P ＜ 0.05).Above mentioned parameters in small-,medium-and high-dose DEX groups were all significantly decreased compared to MIRI group (P ＜ 0.05),and the decrease was most significant in medium-dose DEX group (P ＜ 0.05).Conclusions DEX can attenuate the MIRI in rats and the possible mechanism is suppressing the release of NF-κB p65,which can reduce serum pro-inflammatory cytokines like TNF-α and IL-1β.And mediumdose DEX exhibits better protective effect.

Objective To evaluate the effects of misregistration with different directions and magnitudes between SPECT and CT on image quality and semi-quantification of MPI.Methods The data of 19 healthy volunteers (11 males,8 females ; mean age:(65.3 ± 9.6) years) were retrospectively analyzed.They all had a low pretest likelihood of coronary artery disease according to exercise and rest 99Tcm-MIBI MPI.The CT attenuation correction (CTAC) was performed on a SPECT/CT system.The CT images were manually shifted by 0.5,1.0,1.5,2.0,2.5,3.0,3.5,4.0,4.5 cm distance along the up/down,left/ right,and anterior/posterior axes respectively by using the system built-in software.The counts of the left ventricle were measured using myocardial Bull's eye generated from the reconstructed CTAC images.The image quality and semi-quantification of the CTAC images reconstructed from the raw data with and without shifting were compared and analyzed.Paired t test was used to analyze the data.Results There was no visible artifact with 0.5 cm shifting.The image quality was deteriorated significantly and the counting difference was significant with shifting distance greater than or equal to 1.0 cm.The image artifact of apex wall was mainly due to the upward shift,anterior and apex wall due to the downward shift,septal wall due to the leftward shift,anterior,apex and lateral wall due to the rightward shift,lateral and infero-posterior wall due to the forward shift,anterior,apex and septal wall due to backward shift.The counting difference caused by the downward shift was significantly more severe than that caused by the upward shift ((-9.68±8.06) ％ and (-2.04±1.83)％,t=6.573,P＜0.01) ; and the rightward shift was more severe than the leftward shift ((-9.02± 8.47) ％ and (-4.38±3.67) ％ ; t =1.987,P＜0.05).The image artifacts in anterior,apex and lateral walls were more severe than those in the infero-posterior and septal walls.Conclusions CTAC image artifacts in myocardial perfusion SPECT/CT studies could be caused by misregistration ≥ 1.0 cm.Different directions and magnitudes of shift could result in different degrees of attenuation artifacts at different locations on the original images.