3′-deoxy-3′-18F-fluorothymidine has been described recently as a new positron emission tomography (PET) tracer for imaging tumor cell proliferation. In recent years, more and more clinical research demonstrate that 18F-FLT can image tumor cell proliferation during treatment, and can reflect accelerated reproliferation earlier. it can define tumor subvolumes with high proliferative activity preceding volumetric tumor response, and can predict relapse and prognosis according to the changing status during the treatment.

Objective To evaluate if 18F-FLT PET imaging could be used as a new clinical method to predict tumor radiosensitivity.Methods MDA-MB-231 and LN229 cells were irradiated with doses of 0,8 and 16 Gy of 6 MV photon energy,then soft agar assay and cellular uptake of 18F-FLT were performed on the 2 cell lines.The t test and one-way analysis of variance were used for the two groups and data before and after irradiation.The MDA-MB-231 and LN229 tumor xenografts were prepared by injecting the tumor cells into the right limbs of female BALB/c nu/nu mice.Once tumors reached a diameter of 10 mm,the two types of mice were divided randomly into 3 groups (20 mice per group) according to the irradiation doses (0,8 and 16 Gy).After irradiation,18F-FLT PET imaging and immunohistochemical staining were conducted.Then correlations between 18F-FLT SUVtumor/SUVmuscle ratio (T/M ratio) and TK1 labeling index percentages (LITK1) were tested using linear correlation analysis.Results The survival fraction of MDA-MB-231 and LN229 cells after irradiated with 8 Gy were (59.73 ± 4.3) ％ and (93.41 ± 3.75) ％,respectively (t =-13.20,P ＜ 0.001).When the dose increased to 16 Gy,the survival fraction decreased to (43.57 ±4.06) ％ and (81.77 ± 4.42) ％,respectively(t =-14.24,P ＜ 0.001).In MDA-MB-231 cells,the cellular uptake of 18F-FLT after irradiation with 8 Gy declined rapidly to (18.32 ± 1.38) kBq/105 cells ((128.22 ± 8.24) kBq/105 cells with the dose of 0 Gy,F =266.41,P ＜ 0.01),and maintained this low level till 72 h.For the LN229 cells,the cellular uptake decreased to (9.87 ± 1.30) kBq/105 cells after 8 Gy irradiation ((134.88 ± 6.59) kBq/105 cells with the dose of 0 Gy,F =346.06,P ＜ 0.01),then increased gradually to (127.17 ± 9.08) kBq/105 cells at 72 h (F =346.06,P ＞ 0.05).The dynamic changes of 18F-FLT cellular uptake in the two cells had the same pattern after being treated with 16 Gy irradiation.In the 18F-FLT PET image of MDA-MB-231 tumor mice after 8 Gy radiotherapy,the T/M ratio decreased to 0.78 ± 0.39 at the first day,but it was 2.84 ± 0.29 before radiotherapy (F =39.78,P ＜0.01).Then the ratio increased slowly,and it was still lower than the baseline at 7 d after radiation (F =39.78,P ＜0.01).The same pattern could be seen in the group of 16 Gy irradiation.In LN229 tumor mice treatment with 8 Gy irradiation,the T/M ratio increased to 2.41 ±0.47 at the first day,and it was 1.58 ±0.29 before radiotherapy (F =34.01,P ＜ 0.05).The ratio decreased steadily to 0.66 ± 0.32 (F =34.01,P＜0.05) at 7 d after radiotherapy.However,in the treatment group with 16 Gy,the T/M ratio decreased gradually and reached 0.44 ± 0.22 at 7 d (F =41.85,P ＜ 0.01).A correlation was found between 18F-FLT T/M ratio and LITK1 (8 Gy:r=0.67,0.73; 16 Gy:r=0.73,0.69; all P＜0.01) in both tumor models.Conclusion 18F-FLT PET imaging may be used as a new assay to predict tumor radiosensitivity,but further investigation is needed before clinical application.

Objective To investigate the current prevalent status of endemic fluorosis in the alluvial plain area of the Yellow River in Shandong Province,in order to provide a scientific basis for developing control measures against the disease.Methods Six counties were selected as survey counties by random sampling,ten improvedwater projects were selected in each survey county,for the projects,the operating effect was investigated and water fluoride content was tested;three epidemic villages were chosen as survey villages in each county,the operating condition and the fluoride level of water were investigated in the villages with water improvement projects.Dental fluorosis of children aged 8 to 12 was surveyed,the urinary fluoride and skeletal fluorosis X-ray diagnosis were checked of adults over the age of 25.Water fluoride and urinary fluoride contents were detected via the F-ion selective electrode method,and the prevalence of dental fluorosis of all children aged 8 to 12 was diagnosed based on Clinical Diagnostic Criteria of Dental Fluorosis (WS/T 208-2011),skeletal fluorosis X-ray diagnosis was done based on the National Standard for Diagnosis of Endemic Skeletal Fluorosis (WS 192-2008).Results ①In the six counties,58 improved-water defluoridation projects were investigated,all projects were operated normally,the qualified rate of water fluoride content was 44.83％ (26/58).②A total of 19 villages that had water-improving and defluoridation projects were investigated,and all projects were operated normally,the qualified rate of water fluoride content was 42.11％ (8/19).③The overall rate of dental fluorosis among children aged 8 to 12 years old was 49.28％ (480/974),with the index of dental fluorosis as 1.01 in 19 villages,the prevalence of dental fluorosis was mild.In the qualified villages of water fluoride concentration,the positive rate of dental fluomsis among children aged 8 to 12 was 33.41％ (148/443),dental fluorosis index was 0.65,and the prevalence of dental fluorosis was extremely low;in the exceeding-standard villages of water fluoride content,the positive rate of dental fluorosis among children aged 8 to 12 was 62.52％ (332/531),dental fluorosis index was 1.36,and the prevalence of dental fluorosis was mild;the detection rate of dental fluorosis among children aged 8 to 12 of the villages with qualified fluoride content was lower than the rate of the villages with excessive fluoride (x2 =81.91,P ＜ 0.01).④X-ray detection rate of skeletal fluorosis in adults over the age of 25 was 6.14％ (53/863) in 17 villages,there was no statistically significant difference between the qualified villages and the exceeding-standard villages of water fluoride concentration (x2 =1.55,P ＞ 0.05),X-ray detection rate of skeletal fluorosis in adults was 5.04％ (20/397) and 7.08％ (33/466),respectively.In the qualified villages and the exceeding-standard villages of water fluoride,urinary fluoride geometric average and the exceeding rate of urinary fluoride were 1.50 mg/L,44.16％ (170/385) and 2.09 mg/L,62.58％ (286/466),respectively.In the qualified villages of water fluoride,the exceeding rate of adult urinary fluoride was lower than that in the exceeding-standard villages (x2 =28.58,P ＜ 0.01).Conclusions The prevention and control measures on endemic fluorosis have had some effects in the alluvial plain area of the Yellow River in Shandong Province.But the water fluoride content of water improving defluoridation projects still exceeds the national standard seriously,and endemic fluorosis has not been effectively controlled.Prevention measures should be further strengthened.

Objective To explore the influence on the expression of elF4E and heparanase by antisense oligodeoxyribonucleotides (ASODN) transfection in human bladder carcinoma BIU-87 cells.Methods After transfecting the 2.5,5.O,7.5 μg/ml eIF4E ASODN into BIU-87 cells,at 24 h,48 h and 72 h,a cell control group (no transfection),a blank control group (empty liposomes) and a non-sense control group (transfected with non-sense ASODN) were established.The expression of eIF4E,HPA and mRNA were detected by in situ hybridration.The expression of eIF4 and HPA protein were detected by immunocytochemistry.SPSS 13.0 statistical software was used for statistical analysis.Results The expression quantity of eIF4E protein and mRNA were lower in the experimental groups ( protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:3.55 ±0.52,3.52 ±0.51,3.22.±0.44 respectively; 5.0 μg/ml group:3.43 ±0.47,3.41 ± 0.46,3.19 ± 0.41 respectively ; 7.5 μg/ml group:2.36 ± 039,2.33 ± 0.37,2.05 ± 0.30 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:3.19 ±0.41,3.13 ±0.39,2.90 ±0.38 respectively ; 5.0 μg/ml group:3.07 ± 0.39,2.94 ± 038,2.27 ± 0.37 respectively ; 7.5 μg/ml group:2.22 ± 037,2.06 ± 0.30,1.95 ± 0.29 respectively.All data were less than those in the control groups (P ＜0.05).The expression quantity of HPA protein and mRNA were lower in experimental groups (protein:2.5 μg/ml ASODN treated 24 h,48 h,72 h were:4.44 ±0.55,4.40 ±0.54,3.99 ±0.52 respectively; 5.0 μg/ml group:4.41 ±0.55,4.21 ±0.53,3.77 ±0.50 respectively; 7.5 μg/ml group:4.02 ±0.52,3.98 ±0.52,2.32 ±0.37 respectively.mRNA:2.5 μg/ml treated 24 h,48 h,72 h were:4.12 ±0.51,3.75 ± 0.50,3.63 ± 0.45 respectively ; 5.0 μg/ml group:4.00 ± 0.51,3.71 ± 0.50,3.54 ± 0.44respectively ; 7.5 μg/ml group:3.87 ± 0.52,3.61 ± 0.49,2.08 ± 0.30 respectively).All data were less than in control groups ( P ＜ 0.05 ).There was a positive correlation on expression of HPA protein and eIF4E protein by inhibitory effect of eIF-4E ASODN (protein r=9.23,mRNA r=9.59,P ＜0.01).Conclusion eIF-4E ASODN might be used to inhibit the expression of eIF-4E gene and HPA gene in bladder cancer BIU-87 cells.

BACKGROUND: Autologous bone marrow is the only tissue that contains abundant osteoinductive osteogenitor cells and is the first-choice transplantation materials for treatment of bone nonunion. Artificial bone with osteoinductive capacity can provide a supporting effect for the in-growth of osteocytes. Iliac periosteum can be used for treatment of bone nonunion due to the advantages including abundant blood circulation, easy harvesting, and able to improve local arterial blood supply. BJECTIVE: To treat refractory bone nonunion in limbs using artificial bone with autologous bone marrow combined with iliac periosteum transplantation, and to compare the therapeutic efficacy to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation. METHOD: Thirty-nine refractory bone nonunion limbs from 36 patients were assigned to three groups: artificial bone with autologous bone marrow combined with iliac periosteum transplantation (combination group, n = 19), artificial bone with autologous bone marrow (bone marrow group, n = 9), and autologous iliac periosteum (iliac periosteum group, n = 11). The time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score were evaluated. RESULTS AND CONCLUSION: All initial 39 limbs acquired bone union and were followed up for an average period of 18.5 months. The combination group yielded better therapeutic effects than the bone marrow group and the iliac periosteum group in terms of the time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score (P < 0.05). These findings indicate that artificial bone with autologous bone marrow combined with iliac periosteum transplantation exhibits better clinical therapeutic effects in treatment of refractory bone nonunion in limbs.

Objective To study the clinical characteristics,treatment and prognosis of neonatal VACTERL association.Method The clinical data of newborns diagnosed with VACTERL association from January 2010 to December 2015 were collected and retrospectively analyzed.Result A total of 33 patients diagnosed with VACTERL association were included,including 23 males and 10 females.Among them,17 cases were term infants,15 cases premature infants and 1 case of overdue birth,with an admission age of 1 to 24 days.The most common deformities were cardiac anomalies (C) in 27 cases (81.8％),followed by anal atresia/anorectal malformation (A) in 25 cases (75.8％),renal deformity (R) in 24 cases (72.7％),limb abnormalities (L) in 20 cases (60.6％),Tracheoesophageal fistula (TEF) in 8 cases (24.2％) and vertebral abnormalities (V) in 3 cases (9.1％).11 cases (33.3％) had other deformities.Among these 33 patients,24 cases had 3 types of malformations and 9 cases had 4 types of malformations.The most common combination was ACR (n =8).20 patients had no abnormalites on chromosome karyotype test including 2 patients had normal gene microarray results.16 patients received surgical treatment during neonatal period and 13 of them recovered and discharged.Among the other 17 cases received no surgery,only 1 patient improved and discharged.A telephone follow-up was proceeded in 14 discharged cases at 1 year old.Among them,13 cases had good prognosis,however,the remaining one was dead.Conclusion VACTERL association is a rare non-random combination of multiple malformations.The early discovery and appropriately treatment after diagnosis will improve the prognosis and prevent death.Doctors should reinforce the ability to detect various types of deformities and examine the chromosome and gene properly.

Objective To investigate pulmonary infect flora distribution characteristics of stroke patients with tracheotomy in Intensive care unit (ICU) and analyze the risk factors.Methods A total of 792 cases of ICU stroke patients was selected,including 426 cases of tracheotomy patients,and 366 cases of non-tracheotomy patients.The incidence of lung infections was compared.Bacteriological examination was used for tracheotomy bacteriological studies for lung infected stroke patients with tracheotomy.Bacteria infection's characteristics was observed.The risk factors were analyzed.Results (1) The tracheotomy patient 's lung infection rate was 23.00％,higher than 9.56％ of the non-tracheotomy patients,the difference was statistically significant (X2 =19.125,P ＜0.05);(2) For lung infection-occurred patients with tracheotomy of ICU,gram-negative bacteria infection rate was 63.97％,significantly higher than 19.85％ of gram-positive bacteria and 16.18％ of fungi,the difference was statistically significant (x2 =18.255,17.042,P ＜ 0.01);(3) Lung infection rate of ICU stroke tracheotomy patients with unconscious,dysphagia,hospitalization time ＞ 14 d,blood glucose levels ≥≥7.8 mmol/L,and based diseases was significantly higher than that of patients with conscious,non-dysphagia,hospitalization time ≤＜14 d,blood sugar level ＜7.8 mmol/L,and no based diseases (P ＜ 0.05);(4) Consciousness,dysphagia,hospitalization,blood sugar levels,and the underlying disease were the independent risk factors of lung infection in ICU stroke tracheotomy patients (OR1 =11.528,OR2 =8.046,OR3 =15.174,OR4 =7.795,ORs =10.784,P ＜0.05).Conclusions Gram-negative bacteria is the main reason for pulmonary infections in ICU stroke tracheotomypatients patients with stroke.State of consciousness,invasive treatment,hospitalization,blood sugar levels,and the underlying disease are the independent risk factors.

From July 2006 to April 2008,103 patients(107 hips) undergoing first total hip arthroplasty(THA) were selected from Department of Bone and Joint Surgery,Affiliated Hospital of Luzhou Medical College.According to treatment methods,minimally invasive group(47 cases,47 hips) including 15 cases(15 hips) of necrosis of the femoral head,28 cases(28 hips) of femoral neck fracture,and 4 cases(4 hips) of osteoarthritis,were treated with small posterior skin incision and cementless prosthesis;the routine group(56 cases,60 hips) underwent routine THA.The blood loss,incision length,pain,functional recovery,length of stay,and perioperative complications were recorded.103 patients were followed up,of which minimally invasive THA was followed up for 3-11 months,and routine group followed up for 7-22 months.In the minimally invasive THA group,the patients had less blood loss(P 0.05).The results show that minimally invasive THA has the advantages of less complication,shorter hospital stay,slighter pain and faster function recovery compared to routine THA.

Ojective To compara the individual differences and clinical efficacy of cis-atracurium intermittent bolus injected according to fat-free mass and real body weight. Methods Forty patients (ASAI-II) who had no neuromuscular disease and underwent selective abdominal surgery under general anesthesia were randomly divided into group FFM (n=20) and group RBW(n=20) according to the different administration method. The responses of adductor pollicis to train-of-four (TOF) stimulation were monitored. Anesthesia was induced with propofol 2 mg/kg, fentanyl 3 ug/kg, cis-atracurium 129.6μg/kg (group FFM) or 100μg /kg (group RBW),and maintained with propofol and fentanyl given by target-controlled infusion. Intubation was attempted when T1 reached maximal inhibition. When the TOF stimulus T1 recovery to 5%, both group additional cis-atracurium 64.8 μg/kg (group FFM) or 50μg /kg (group RBW). The onset time, nonresponsive time, clinical duration, recovery index, pharmacological duration, cis-atracurium consumption, interval and frequency were recorded. Results No significant differences were found in general, interval, frequency,onset time, clinical duration, nonresponsive time,recovery index, pharmacological duration between the two groups (P > 0.05); There were significant differences in the cisatracurium consumption between two groups (P < 0.05); Compare with the group RBW, the differences of pharmacological duration and nonresponsive time between different individuals in group FFM were smaller (P < 0.05). Conclusion It can reduce the individual differences of muscle relaxant effect to apply cis-atracurium and cis-atracurium consumption according to fat-free mass.

Objective To discuss the safety and effectiveness of the drainage of perinephric abscess with retroperitoneal laparoscopy.Methods The clinical data of 12 cases undergoing the drainage of perinephric abscess with retroperitoneal laparoscopy were analyzed retrospectively.There were 3 males and 9 females,with a mean age of 47 years.All the 12 cases presented with lumbar pain and fever,7 cases had chill,5 cases had irritative symptom of bladder,and 4 cases had nausea and vomiting.The average course was 9 d,and the average diameter was 6.4 cm.Four cases were in the left side,and 8 in the right side.The main complications included type-2 diabetes (5 cases),type-1 diabetes (1 case),kidney stones (2 cases) and systemic lupus erythematosus (1 case).All the 12 cases were treated with antibiotics.The indexes were recorded,including operative time,intraoperative blood loss,purulent fluid volume,postoperative indwelling time of the drainage tube,postoperative time of body temperature returned to normal,postoperative hospital stay,and complication rate.Results All the 12 operations were successful without peritoneal damage,kidney damage or other complications.The mean operative time was 56 (48-95) min,the mean intraoperative blood loss was 127 (60-150) ml,the mean intraoperative purulent fluid volume drawed out was 128 (120-230) ml,the mean postoperative indwelling time of the drainage tube was 9 (6-12) d,the mean postoperative time of body temperature returned to normal was 3 (2-4) d,and the mean postoperative hospital stay was 10 (7-12) d.All the patients were followed up for an average of 6.5 (6-12) months,no recurrence occured.Conclusions The drainage of perinephric abscess with retroperitoneal laparoscopy has the advantages of definite effectiveness,complete drainage,little injury and rapid recovery.The drainage of perinephric abscess with retroperitoneal laparoscopy by skilled urologists is safe.