PET/CT is a useful method which combines metabolic and anatomic imaging. It has already a-chieved good results in differential diagnosis of pancreatic malignant disease, evaluating therapeutic effect, monitoring tumor recurrence and metastasis. This article will summarize the clinical utilization of PET/CT in the diagnosis and treatment of pancreatic cancer.

The growing trend of childhood obesity has attracted much attention globally.Overweight and obesity are not only popular in developed countries,but have spread to developing countries.China has entered an overall epidemic stage of childhood obesity.Studies have shown that obesity does not only impairs children's health,but also leads to health hazards in adult stage.Diabetes,coronary heart disease and other cardiovascular diseases may take place sooner or the incidence may become higher.The causes of obesity include genetic,early life events,physical activity patterns,diet and social psychological factors.This article reviews the current epi-demic status and the influencing factors of childhood obesity worldwide.

[Objective]To introduce the effect of reversed sural neurofasciocutaneous flap with muscle repairing the soft tissue defect of foot and ankle.[Method]Reversed sural neurofasciocutaneous flap with muscle was applied for repairing the soft tissue defect simultaneous open fracture of tibia lower section 6 cases,the soft tissue defect simultaneous chronic osteomyelitis of tibia lower section 5 case,the soft tissue defect of sole of foot simultaneous calcaneus epicarp 3 case, the soft tissue defect of sole of foot simultaneous calcaneus osteomyelitis or dead space 2 case. The scope of the flap was 18 c m?13 cm～11 c m?7 c m and that of the gastrocnemius flap was 4 cm?3 cm～9 c m?6 cm,the thickness was 1～3 cm,the skin flap was bigger than the muscle flap.[Result]Muscle side of the muscle flap was errhysising actively and the skin flap was good circulation duing operation, the muscle flaps were used clinically in 16 patiens all survived completely after operation. All cases were followed up from 5 to 17 months ,incision of open fracture healed primarily, osteomyelitis without reoccurring, the muscle flaps were satisfactory in appearance,feel recovered and walk well.[Conclusion]Reversed sural neurofasciocutaneous flap with muscle has sufficient blood supply and high survival rate,so it is an effective and feasible method in repairing the soft tissue defect of foot, ankle and tibia lower section in special cases.

Objective:To prepare anti-human PSA(Prostate Specific Antigen)monoclonal antibodys(McAb)and identify their distinct biological function.Methods:Prostate Specific Antigen(PSA)was purified by salting out,ion exchange and gel filtration method from human sperm.The purity and contents of the objective protein was detected by SPS-PAGE and f-PSA EiAsy.BALB/c mice were immunized with the purified PSA purified.Then the immunized splenocytes were isolated and fused with a hypoxanthine-aminopterin-thymidine-sensitive mouse myeloma cell line SP2/0.Positive clones were screened by limiting dilution method.After acquisition of the hybidomas secreting anti-PSA monoclonal antibody,investigation of their sub-class isotype,binding affinity and specificity were followed.Results:Fifteen hybridoma cell lines that could continuously secret anti-PSA monoclonal antibody were obtained.An Ig subclass was classified as IgG2a and the other were IgG1.Conclusion:This McAb is propitious to establish PSA-ELISA diagnose reagent.

Objective To survey village doctors'knowledge,demand and behavior of health management,to provide scientific evidence for village people's health self-management.Methods Prepared a self-designed question-naire and make it completed by 106 village doctors chosen at random from 106 different villages in the eight towns in Guangzhou's two mountainous districts.Results The average age of the village doctors was(50.9 1 ±7.84)years, 36.79% of them had the ultimate diploma of a health technical school,and the average knowledge rate of health man-agement was 30.09%.There was remarkable difference among the 3 age groups which disclosed statistic value(χ2 =112.900,P =0.000).The 35-44 age group was the highest in the knowledge rate of health management (52.61%). The doctors with a ultimate technical diploma vary in the knowledge rate (the highest was 47.44%),which also had statistic value(χ2 =112.900,P =0.000).Only 2.83% of the village doctors believed that their health management skill can completely meetthe current demand and 3.77% can.18.87% believed that training about health management was very meaningfuland 25.47% meaningful.63.21% (most required by the health bureau) expected to receive training.16.98% didn't receive such training in the recent year because they thought it was un-necessary or not available.11.32% of the village doctors were willing to pay for the health management training,while 97.17% had never taken such training on their own expenses.Conclusion Village doctors are mostly elderly,low-educated,and insufficient in the professional knowledge of health management.Without the corresponding motivations and regulations,they are not enthusiastic about the training.It is suggested that the local authorities pay more attention to the buildup of the village health stations and improve the structure,knowledge,and earning of the village doctor group so as to ensure the effective health management service for the masses in villages.

Objective To investigate the demands and problems of the sharing and construc-tion of teaching resources in medical universities. Method A self-designed questionnaire named The questionnaire of the present situation and demand of teaching resources sharing platforms in medical universities in China was used to conducted in all the attainders during a national teaching resources meeting, and SPSS 17.0 was used to analyze the data. Results Among 125 valid questionnaires, 117 people (93.6%) think it's necessary to establish the resources sharing platform, what's more 108 people (86.4%) believe that education resources sharing platform is very helpful for teaching, and multimedia materials, online courses, course wares, teaching cases, website of subject resources and other educa-tion resources should be widely shared. Our investigation has involved 48 medical universities from all over the country, in which 33 medical universities have teaching resources sharing platform. However, 20 (60.6%) of the universities have still not updated the content on time. There are 10 main factors which influence the using of the education resource sharing platform, in which 105 (84%) of them have con-sidered the factor as backward concepts, 91 (72.8%) think that there exist problems in resource con-struction mechanism, 76 (60.8%) think to be the standardized and universal problems. Conclusion It is necessary to build the education resource sharing platform. In all, we should change the traditional education concept and consciousness, strengthen mechanism of management, and exploit high quality education resource to improve the sharing level of education resource in medical universities.

The heptadecatungstodiphosphate substituted by L a(Ⅲ) with the formula　α2-K7P2W17O61(La.OH2 ) (P2W 17La) was prepared by vacant refilling method. The anion of single substitu ted Dawson-type tungstophosphate salt was doped into the polypyrrole (PPY) film on a glassy carbon electrode (GC) by electrochemical method to prepare the chem ically modified electrode (P2W17La/PPY/GC). It maintains not only t he electrochemical activity and electrocatalytic property of P2W17L a, but also has good stability and sensitivity. In 0.50 mol/L HCl solution, th e first cathodic peak of P2W17La doping in polypyrrole film can cat alyze well the electroreduction of nitrite. The catalytic current was proporti onal to the concentration of nitrite between 6.0×10-5 and 1.0×10-2 　mol/L.

Objective To observe the effects of transplantation of bone marrow stem cells(BMSCs)transfected with bone morphogenetic protein-2(BMP-2)on fracture healing in rats with diabetes so as to provide a new therapy for diabetic fractures.Methods Fifty male adult Wistar rats aged six weeks randomized to the control group and experimental group were all employed to establish models with diabetic fractures.Under high glucose condition,BMSCs were transfected with BMP-2 by adenovirus vector in vitro.BMSCs transfected by BMP-2 were transplanted into the fracture area of rats in the experimental group,while non-transfected BMSCs into the corresponding area of rats in the control group.X-ray examination was performed at 1,2,3,4 and 6 weeks after transplantation.Bony calluses were collected for HE staining and gray scales of BMP-2 in calluses were determined by immunohistochemical method.Meanwhile,serum levels of BMP-2 were measured by ELtSA.Results The gray scales of BMP-2 in the calluses were 83±3 in the experimental group and 118±4 in the control group at four weeks(P＜0.01).The serum concentrations of BMP-2 were(203.80±8.96)ng/L in the experimental group and(139.15±4.19)ng/L in the control group at four weeks(P＜0.01).Conclusion Transplantation of BMSCs transfected by BMP-2 promotes fracture healing in diabetic rats.

Objective To compare the efficacy and safety of full-thickness peroral endoscopic myotomy (POEM) and circular myotomy for patients with severe achalasia.Methods The clinical data of 123 patients with severe achalasia who were admitted to the Second Xiangya Hospital of Central South University from August 2011 to May 2013 were retrospectively analyzed.Seventy patients who received full-thickness POEM were in the full-thickness myotomy group,and the other 53 patieuts who received circular myotomy were in the circular myotomy group.The clinical efficacies and incidences of complications of the 2 groups were compared.Patients in the 2 groups were followed up at the out-patient department till May 2014.The consecutive measurement data were presented by (x) ± s and analyzed using thc t test; the non-consecutive data were presented by M (range) and analyzed using the Wilcoxon rank test.Data before and after operation were compared using the repeated measure of analysis of variance.The count data were analyzed using the chi-square test.Results All the patients successfully received POEM.The operation time of the full-thickness myotomy group and the circular myotomy group were (57 ± 8)minutes and (63 ± 12)minutes,with significant difference between the 2 groups (t =3.421,P ＜0.05).The incidences of complications of the full-thickness myotomy group and the circular myotomy group were 14.3％ (10/70) and 11.3％ (6/53),with no significant difference between the 2 groups (x2=0.234,P ＞0.05).Atotal of 119 patients were followed up,with the median time of 18 months (range,12-24 months).The Eckardt scores at postoperative month 6 and 12 were 0 (range,0-3) and 0 (range,0-3) in the full-thickness myotomy group,and 0 (range,0-2) and 0 (range,0-3) in the circular myotomy group,with no significant difference between the 2 groups (Z =0.525,1.476,P ＞ 0.05).The sussess rates of the full-thickness myotomy group and the circular myotomy group were 98.6％ (69/70) and 98.1％ (52/53),with no significant difference between the 2 groups (x2=0.040,P ＞ 0.05).The diameters of the esophagus at postoperative month 6 of the full-thickness myotomy group and the circular myotomy group were (3.2 ± 0.3) cm and (3.4 ± 0.4) cm,with no significant difference between the 2 groups (t =1.927,P ＞ 0.05).The diameters of the esophagus at postoperative month 6 and 12 were significantly lesser than (5.9 ± 1.0) cm and (5.9 ± 1.0) cm before operation (F =780.923,493.018,P ＜ 0.05).No recurrence was detected in the 2 groups during the follow-up.Conclusion The short-term efficacy and incidence of complications of full-thickness myotomy and circular myotomy are comparable,while the operation time of patients who received full-thickness myotomy is shorter.

Objective To investigate the risk factors and incidence of gas-related complications in peroral endoscopic myotomy for easophageal achalasia.Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected.Potential risk factors for gas-related complications were analyzed by univariate and multivariate analysis.Results The incidence of gas-related complications was 10.2％ (22/216).Univariate analysis showed risk factors for complications were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,tunnel width ≤3 cm,degree of myotomy,and operation time (P ＜ 0.05),while multivariate analysis showed the risk factors were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,and tunnel width ≤3 cm(P ＜ 0.05).Conclusion Simple longitudinal incision for tunnel entry,tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas-related complications in POEM,while myotomy depth is not.