Objective To develop multimedia network testing system on"three-primary" Training.Methods Java was used to develop the application program,MySQL was used to establish database of test questions.The stable communication protocol(SOAP,Web service,etc.) and link were applied.Results With this system,random test questions and choices are provided;questions are answered by human-computer interaction;answer time is restricted;the paper is automatically scored;database of test questions is managed openly;test paper is automatically set.Conclusion This testing system is highly automatic,secure,impersonal,extensible,stable,open and efficient.

Objective To investigate the effective indicators for the prognosis assessment in pa?tients with multiple myeloma (MM) by 18F?FDG PET/CT imaging. Methods A total of 36 patients(22 males, 14 females;median age 63.5 years) with MM confirmed by clinical or pathology from July 2007 to November 2014 were retrospectively reviewed. The number of lesions detected by PET/CT, the number of lesions with SUVmax>2.5, the SUVmax and MTV of each lesion were calculated. The correlation analysis was performed between the number of lesions detected by PET or CT,the number of lesions with SUVmax>2.5, the SUVmax , MTV and serumβ2?microglobulin (β2?M) , respectively. The patients were divided into differ?ent groups according to the development of lesions and the survival situation during the follow?up ( 4-92 months) . Kaplan?Meier analysis and multivariate Cox model were used to analyze the prognostic significance of the number of lesions detected by PET or CT and the number of lesions with SUVmax>2.5, the SUVmax and MTV. Results Both the number of lesions with SUVmax>2. 5 and MTV showed positive correlations with blood β2?M (r=0.776, 0.954, both P<0.001), while the number of lesions detected by PET/CT and SUVmax were not correlated with β2?M ( r=0.053, 0.063, 0.398, all P>0.05) . The number of lesions with SUVmax>2.5 and MTV in the progressive group( n=14) were significantly higher than those in the regressive group(n=22):66.57±4.59 vs 31.95±4.75, t=4.95, P<0.001;(287.54±31.94) cm3 vs (72.17±14.35) cm3, t=6.93, P<0.001. The number of lesions with SUVmax>2.5 and MTV were significantly higher in the dead group(n=15) than those in the survival group(n=21):65.73±4.32 vs 30.90±4.87, t=5.10, P<0?001;(267.28±34.89) cm3 vs (76.39±15.67) cm3, t=5.49, P<0.001. The best cutoff values for predicting pro?gression?free survival and overall survival were both 42 for the number of lesions with SUVmax>2. 5, and those were 114.74 and 105.48 cm3 for MTV, respectively. The progression?free survival rate was worse in the patients with higher index than those with lower value (χ2=18.20, 29.74, both P<0.001) , and the same re?sult was also seen for the overall survival rate (χ2=19.07, 25.34, both P<0.001) . Conclusion The number of lesions with SUVmax>2.5 and MTV on 18 F?FDG PET/CT images could predict the progression?free survival and overall survival rates of patients with MM, which may provide accurate prognosis information.

Objective To investigate the differential diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT for benign and malignant vertebral compression fractures in patients with malignant tumor.Methods From August 2007 to July 2016,79 patients with vertebral compression fractures were enrolled.Patients were divided into 3 groups based on clinical follow-up or pathological results:osteoporosis group (n =40;13 males,27 females,median age:77 years),metastasis group (n=27;18 males,9 females,median age:64 years) and myeloma group (n=12;7 males,5 females,median age:67.5 years).Characteristics of 18 F-FDG PET/CT imaging and maximum standardized uptake value (SUVmax) of involved vertebrae were compared using x2 test,one-way analysis of variance and the least significant difference t test.SUVmax of normal L2 vertebral body was regarded as the control.Results (1) There were 53,41 and 16 compression fractures identified in osteoporosis group,metastasis group and myeloma group,respectively.No paravertebral soft tissue mass or spinal accessory involvement was found in osteoporosis group.In metastasis group,14(34.15％,14/41) paravertebral soft tissue masses and 28 spinal accessory involvements (68.29％,28/41) were detected,and the numbers were 2 (2/16) and 16 (16/16) for myeloma group respectively.There were significant differences for paravertebral soft tissue masses and spinal accessory involvements among 3 groups (x2 values:21.75,73.10,both P＜0.01).(2)In osteoporosis group,all lesions displayed strip-like (100％,53/53) 18F-FDG accumulation.In metastasis group,there were nodular accumulation (12.20％,5/41),bulk accumulation (43.90％,18/41),and irregular accumulation (43.90％,18/41).In myeloma group,the 18 F-FDG accumulation were strip-like (14/16) and irregular (2/16).The accumulation patterns among 3 groups were significantly different (x2=103.67,P＜0.01).(3)SUVmax of osteoporosis group,metastasis group,myeloma group and control group was 4.00±0.14,7.33±4.05,4.17±0.39 and 2.33±0.06,respectively (F=46.45,P＜0.01).The SUVmax between each 2 groups were significant (t values:12.38-29.51,all P＜0.05) except for that between osteoporosis group and myeloma group (t=0.26,P＞0.05).Conclusions Strip-like 18F-FDG accumulation,SUVmax of vertebral body,paravertebral soft tissue masses and spinal accessory involvements in 18F-FDG PET/CT imaging are important for differential diagnosis of benign and malignant compression fractures.