Objective To explore the clinical value of dual-energy CT lung perfusion imaging and perfusion scintigraphy in acute pulmonary embolism (PE) rabbit models. Methods Acute PE models were established in 20 rabbits with femoral vein injection of sponge as embolus materials, and 4 rabbits were injected saline as control group. Two hours after embolization, dual-energy CT and perfusion scintigraphy imaging were performed respectively. Taking the pathologicall findings as the reference standards, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both imaging methods were compared. CT values and enhancement degree (overlay value) of the embolic areas and normal pulmonary parenchyma were measured in DEPI image after embolization. Results Normal lung was color-coded as homogeneously yellowish red, perfusion scintigraphy displayed rarefaction or absence. The sensitivity, specificity, PPV, NPV of DEPI was 100%, 97.50%, 95.24%, 100%, and of perfusion scintigraphy was 67.50%, 81.25%, 64.29%, 83.33%, respectively. Increased CT values and overlay values of embolism areas in DEPI images were lower than those of normal pulmonary parenchyma (P<0.05). Conclusion DEPI has higher sensitivity and specificity than perfusion scintigraphy for detection of pulmonary emboli in an acute PE rabbit models.

Purpose To study the reversal effect on multidrug resistance (MDR) by TNF-α gene combined with verapamil (VRP) or tamoxifen (TAM). Methods By using recombinant retrovirus vector, TNF-α gene was transfected into multidrug-resistant human breast cancer cell line MCF7/ADR. The TNF-α secreting cell clone MCF7/ADR-TNF was obtained by G418 screening. The integrating and secreting of TNF-α were analyzed by PCR and ELISA. MTT assay and formula"I = d/D1 + d/D2" were used to evaluate the reversal effect of multidmg resistance with TNF-α gene combined with verapamil or tamoxifen. ResultsThe level of TNF-α secreted by MCF7/ADR-TNF was 1 737 pg/ml (106cells/48 h). Compared with control,the resistance to ADR of MCF7/ADR-TNF was reversed by 1.6 times. The reversal effect produced by combination of TNF-α gene and VRP was antagonistic. The combination of TNF-α gene and TAM produced synergic effect (interaction index I = 0.64). ConclusionsTNF-α gene combined with TAM has synergic effect on reversing MDR.

Objective To investigate clinical features of chronic actinic dermatitis (CAD) in Kunming of Yunnan Province.Methods From October 2008 to October 2013,CAD in-patients in our hospital were selected and their general conditions,outcomes of photo-sensitive test and photo-patch test were analyzed in details.Results (1) Among 169 CAD patients,gender ratio (male:female) was 8.9:1.The lesions were mainly distributed on the exposed areas.(2) Photo-sensitive tests of 93 patients showed that the average value of UVA-MPPDwas 7.39 JPcm2 and that of UVB-MED was 20.91 mJPcm2.(3) The results of photo-patch test in 83 patients showed that 48 patients (67.8％) had positive reactions in patch test,and the most common contactant was balsam peru.Fifty-eight patients (69.9％) had positive reactions in photo-patch test indicating that the most common contactant in photo-patch test was balsam peru.Conclusions CAD appears mostly in the middle aged and the aged males and the lesions are mainly distributed on exposed areas.The most common contactants in photo-patch test are balsam peru and perfumed compounds.

Objective To evaluate the clinical efficacy of oral taking traditional Chinese medicine with functions of tonifying kidney, nourishing blood and soothing liver and external application treatment of premature ovarian failure(POF). Methods 40 patients of deficiency of liver-yin and kidney-yin type POF in Gynecology Department of Xiyuan Hospital CACMS from July 2009 to July 2013 were collected and administrated with traditional Chinese medicine with functions of tonifying kidney, nourishing blood and soothing liver and external treatment for 3 months. The changes of menstruation situation, symptoms and serum sex hormone were compared before and after the treatment. Results ① Menstruation integral were reduced after the treatment, showing a statistical significance compared with those before the treatment(t=5.694,P<0.01). ② Symptoms integral were reduced after the treatment, showing a statistical significance compared with those before the treatment(t=21.828,P<0.01). ③ Serum FSH, LH were decreased and Serum E2 were increased after the treatment,showing a statistical significance compared with those before the treatment(P<0.05). ④ The total effective rate was 92.5%(37/40). Conclusion Traditional Chinese medicine with functions of tonifying kidney, nourishing blood and soothing liver are effective for treating POF. These methods had proven to improve ovarian function by decreasing high level of FSH and LH, whereas enhancing the estrogen level, and therefore promote menstruation cycle.

Objective Different grades of glioma lead to different clinical course,treatments and prognosis,thus it is important to predict histological grades of glioma preoperatively.18F-FDG PET/CT imaging and MR perfusion imaging is considered a promising method to evaluate glioma,and the present study was to evaluated the contribution of 18F-FDG PET/CT imaging and MR perfusion imaging in grading intracranial glioma.Methods Eighteen consecutive patients with suspected primary brain glioma underwent 18F-FDG PET/CT scanning and MR perfusion scanning in our hospital.To evaluate the relative sensitivity among standardized uptake value (SUV),L/W,and rCBV,the PET/CT imaging were analyzed,and the SUV and Lesion-to-white matter ratio (L/W) were calculated.The rCBV ratios of lesions were calculated relative to the region of interest (ROI) values in contra lateral normal white matter.Results Eighteen brain gliomas were confirmed by pathologic diagnosis,including 7 WHOⅡ tumors,6 WHOⅢ tumors,and 5 WHOⅣ tumors.SUV and rCBV could not differentiate between WHOⅡ tumor and WHOⅢ tumor,however significant difference could be found among the three using L/W.Conclusion 18F-FDG PET/CT imaging and MR perfusion imaging could offer more diagnostic information than conventional MRI.All of the three semiquantitative data offer some contribution in grading intracranial gliomas,and L/W might be the best one.

OBJECTIVE:To evaluate the affordability of 3 anti-tumor targeted drugs gefitinib,trastuzumab and sunitinib in ur-ban and rural residents of Hubei province,and to provide reference for medical insurance price admission of anti-malignant tumor targeted drugs in China. METHODS:Referring to the incidence of malignant tumor stated in statistical yearbook of Hubei province and income data of urban and rural residents in Hubei province,based on the policy of reducing the price of imported drugs by 50% mentioned in the national drug price negotiations,and assume the drugs are included in the medical insurance reimbursement list,WHO/HAI standard survey method,catastrophic expenditure evaluation method and poverty effect evaluation method were ad-opted to calculate the affordability of 3 drugs. RESULTS:According to WHO/HAI standard survey method,increment of payment for 3 drugs were 64.00%-74.00% before and after 50% discount and reimbursement. According to catastrophic expenditure evalua-tion method,50% discount of gefitinib and reimbursement gefitinib,trastuzumab and sunitinib in urban area would result in cata-strophic expenditures of 20.00%、59.28% and 35.48% patients;in rural area,would result in catastrophic expenditures of 50.63%、74.72% and 75.93% patients. According to poverty effect evaluation method,50% discount of 3 drugs and reimbursement caused less than 31.95% urban and rural patients falling to poverty. CONCLUSIONS:Fifty percentage discount of 3 anti-tumor targeted drugs mentioned in the national drug price negotiations cause the economic burden more serious for rural residents than urban resi-dents. In the formulation of policies,the corresponding reimbursement ratio should be adjusted according to urban and rural areas, drug price and disease types for a balance of patients with different economic burden.

Objective: To investigate the value of positron emission tomography/computerized tomography(PET/CT) with fluorine-18-labeled fluorodeoxyglucose(18FDG) for gastric carcinoma.Methods: Thirty-two patients(25 males,7 females,aged 31-82 years) suspected of gastric carcinoma underwent whole-body PET/CT after taking in 600 ml of water to distend the gastral cavity.The maximal standard uptake value(SUVmax) of the region of interest(ROI) in PET and the maximum width of the gastric wall in CT were analyzed.Pathological specimens were obtained from all the patients during surgery or gastroscopy.Results: 18FDG PET/CT found gastric carcinoma in 24 of the patients.The rates of positive and negative prediction and the accuracy of PET/CT in the diagnosis of the disease were 92.3%,100% and 93.8%.SUVmax was positively correlated with the maximum width of the gastric wall,but they exhibited no statistically significant differences between the patients with involved lymph nodes and those without.Based on the PET/CT findings,the 24 gastric carcinoma patients were clinically classified as follows: 9 in stage Ⅰ,1 in stage Ⅰ-Ⅱ,3 in stage Ⅱ,1 in stage Ⅲ and 10 in stage Ⅳ.Conclusion: 18FDG PET/CT is highly valuable for gastric carcinoma in its diagnosis,the evaluation of its biological behavior and determination of its treatment strategies.

Objective: To analyze the New Cooperative Medical System ( NCMS ) funds and Individual afford-ability of anti-tumor targeted drugs under different medical insurance entry price, and to provide the basis for establis-hing the access price for medical insurance. Methods: Choosing Conmana or Kemer ( the lung cancer targeted drug) and Herceptin (breast cancer targeted drug) to analyze the Wuhan NRCMS operating status from 2012 to 2014, use tumor surveillance data from Hubei Province during the period from 2011 to 2015;consult clinical experts to form expert consensus price, refer to the Jiangsu Province Access Price and National Negotiation Price, and explore the fund bal-ance and individual affordability when the afore-mentioned two kinds of drugs can be compensated by medical insurance under different price. Results:The basic account balances of NRCMS in Wuhan from 2016 to 2018 are-11. 948 million Yuan, 2. 513 million Yuan and 82. 955 million Yuan when Kemer can be compensated by medical insurance under Na-tional Negotiation Price. Taking the compensation of Herceptin under National Price after the bargaining, the basic ac-count balances are -26. 901 million Yuan,-35. 962 million Yuan and 17. 542 million Yuan respectively. The rate of poverty caused by illness falls to 33. 40% from 45. 85% when Conmana can be compensated by Medical Insurance un-der National Negotiation Price, while this rate falls to 45. 42% from 46. 00% for Herceptin. Conclusion:The two kinds of drugs can be afforded by the Wuhan NRCMS after the medical insurance access price is negotiated by the govern-ment, but the individual affordability of Herceptin at the National Negotiation Price is worse.

Objective: To understand the prevalence and risk factors for functional constipation (FC) among high school students in Chongming District of Shanghai. Methods: A cross sectional study was conducted in Chongming District of Shanghai from March-June 2019. A total of 4 969 adolescents under the age of 18 were recruited high schools, using a stratified random sampling technique. A validated self administered questionnaire on Rome IV criteria for diagnosing FC and predisposing factors was filled by each student in a classroom setting. Results: The prevalence of FC among middle school students in Chongming District of Shanghai was 13.95%. There were no significant differences in the prevalence between males and females, middle and high school groups, and urban and rural areas( P ＞0.05). In senior high schools, students in the graduation year were more likely to suffer from FC(17.36%，130/749) than other students (13.77%，201/1 460)( χ 2=5.01, P =0.03). The prevalence of FC in the key senior high schools(18.23%，115/631) was significantly higher than that in ordinary high schools (13.07%，49/375)( χ 2=7.43, P =0.02). Multivariate Logistic regression analysis showed that frequency of physical exercise, and consumption of spicy foods, proportion of spicy foods in the diet, consumption of vegetables, a lower proportion of vegetables in the diet, drinking water, anorexia, quality of sleep and school type were associated with FC in high school students ( OR=0.11-7.71, P <0.05). Conclusion FC is prevalent among high school students on Chongming District of Shanghai, especially among middle school graduates, and many risk factors were significantly associated with the occurrence of FC.

BACKGROUND: The new emerging avian influenza A H7N9 virus, causing severe human infection with a mortality rate of around 41%. This study aims to provide a novel treatment option for the prevention and control of H7N9. METHODS: H7 hemagglutinin (HA)-specific B cells were isolated from peripheral blood plasma cells of the patients previously infected by H7N9 in Jiangsu Province, China. The human monoclonal antibodies (mAbs) were generated by amplification and cloning of these HA-specific B cells. First, all human mAbs were screened for binding activity by enzyme-linked immunosorbent assay. Then, those mAbs, exhibiting potent affinity to recognize H7 HAs were further evaluated by hemagglutination-inhibiting (HAI) and microneutralization in vitro assays. Finally, the lead mAb candidate was selected and tested against the lethal challenge of the H7N9 virus using murine models. RESULTS: The mAb 6-137 was able to recognize a panel of H7 HAs with high affinity but not HA of other subtypes, including H1N1 and H3N2. The mAb 6-137 can efficiently inhibit the HA activity in the inactivated H7N9 virus and neutralize 100 tissue culture infectious dose 50 (TCID50) of H7N9 virus (influenza A/Nanjing/1/2013) in vitro, with neutralizing activity as low as 78 ng/mL. In addition, the mAb 6-137 protected the mice against the lethal challenge of H7N9 prophylactically and therapeutically. CONCLUSION The mAb 6-137 could be an effective antibody as a prophylactic or therapeutic biological treatment for the H7N9 exposure or infection.
Animals ; Antibodies, Monoclonal/therapeutic use* ; Antibodies, Neutralizing/therapeutic use* ; Antibodies, Viral ; Hemagglutinins ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Influenza A Virus, H7N9 Subtype ; Influenza Vaccines ; Influenza in Birds ; Influenza, Human/prevention & control* ; Mice