Objective To compare the clinical value of 18F-FDG PET imaging and 99Tcm-MDP whole body bone imaging in detection of bone metastases. Methods 43 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. 28 of them were with confirmed bone metastases by other examinations or follow-up and the remaining 15 were confirmed without bone metastases. The results of the 2 different modalities were analyzed. Results Among 28 patients with confirmed bone metastases, PET and MDP accurately diagnosed 26 and 27, respectively. The sensitivity of them were 92.9 %(26/28), 96.4 %(27/28), Among the remaining 19 cases without bone metastases, PET and MDP correctly gave 14 and 8 negative results, respectively. The specificity of them were 93.3 %(14/15), 53.3 %(8/15), and accuracy of them were 93.0 %(40/43), 81.4 %(35/43). The differences between specificities and accuracies of the two methods were significant, while no significant difference between the sensitivities of the two methods. Conclusion For the detection of bone metastases in patients with malignant tumors, 18F-FDG PET showed a similar sensitivity but better specificity and accuracy compared with 99Tcm-MDP bone scan. For patients with suspected bone metastases, negative finding or single hot spot in 99Tcm-MDP imaging, 18F-FDG PET imaging was recommend as a further and complementary assessment of bone metastases.

ObjectiveTo observe the dynamic changes of blood perfusion and hypoxic status by CT perfusion imaging and hypoxia imaging in patients with non-small cell lung cancer (NSCLC) after treatment with recombinant human endostatin (RHES). MethodsA total 15 patients with NSCLC were randomly divided into treatment group (n = 10) and control group (n = 5). The patients in treatment group continuouly received the treatment with RHES (7.5 mg/m2) by intravenous infusion for ten days, and CT perfusion imaging and hypoxia imaging were performed at day 1, 5 and 10,respectively. The time window' was observed with the blood perfusion status and hypoxic changes.ResultsIn the treatment group, capillary permeability surface (PS) and tumor to normal tissue (T/N) were firstly decreased, and then increased. Their lowest points occurred at about the fifth day. PS showed statistical significance compared with the first day (q1.5 = 12.05, P＜0.01 ) and no significance compared with the tenth day(q10.5 = 2.79, P=0.69), while T/N showed a significant difference between above time points (q1.5 = 73.81, q10.5 = 20.6, P = 0.00).Blood flow (BF) was firstly increased, and then decreased.Its highest point appeared at about the fifth day with statistical significance compared with the first and tenth day (q1.5 = 12.29, q10.5 = 10.48, P＜0.01 ). All the PS,BF and T/N between the fifth day in treatment group and the control group showed statistically significance (all P ＜ 0.01 ).Conclusions The time window of recombinant human endostatin improving blood perfusion and hypoxic status in non-small cell lung cancer is within about one week after administration.

Sixty four patients undergoing endoscopic sinus surgery were randomly divided into two groups.In nimesulide group (n=32) patients were given nimesulide capsule 100 mg after surgery and 32 patients in control group were given 100 mg vitamin C as placebo.The visual analogue scale (VAS) was used to evaluate the degree of pain during withdrawing nasal packing.The VAS value of the nimesulide group was 2.8±1.1 3 h after surgery and 2.7±1.2 during with drawing nasal packing,that of control group was 6.7±0.6 and 8.3±0.6,respectively (both P<0.01).The results revealed that nimesulide had a siguificant analgesic effect in endoscopic sinus surgery.

OBJECTIVE:To standardize periooperative prophylactic application of antibiotics. METHODS:According to the characteristics of orthopaedic and parenchyma surgery,classifying evaluation table of typeⅠincision infection risk was designed sci-entifically and rationally. The individual application of antibiotics in surgery patients had been achieved through infection risk evalua-tion. High risk typeⅠincision patients used antibiotics rationally and low risk patients seldom used or didn’t use at all. RESULTS:Through using infection risks classifying table,the rate of antibiotics prophylactic application in typeⅠincision drops from 74.10%to 28.68%,and and the per capita duration of antibiotics prophylactic application shortened from 4.23 d to 2.21 d. The postopera-tive infection rate remained the same. CONCLUSIONS:Through infection risk classifying evaluation,individual application of anti-biotics can be achieved in surgery patients,so as to promote rational use of antibiotics for prophylactic use,reduce antibiotics dos-age and antibiotics abuse under the condition of controllable surgery infection.

Dendritic Cell Sarcoma, Interdigitating ; Humans ; Lymph Nodes ; Male ; Middle Aged

OBJECTIVETo investigate the synergistic effect of transforming growth factor-beta1 (TGF-beta1) and platelet-derived growth factor-BB (PDGF-BB) on the expression of integrin beta3, in periodontal membrane of rat orthodontic tooth.

METHODSAn orthodontic tooth movement model was established. Up to 32 experimental rats were randomly divided into four groups according to a random number table. The four groups were injected with 1% PBS, TGF-beta1 (5 ng), PDGF-BB (10 ng), and combined TGF-beta1 (5 ng) and PDGF-BB (10 ng) in the buccal submucosal, respectively. The volume injected in each group was 0.1 mL. The animals were then sacrificed on the 10th day. The left maxillary first molar and periodontal tissue were taken. Different expressions of integrin beta3 were detected in periodontal tissues through immunohistochemistry. Mean optical density (OD) values of the positive fields were examined. The data obtained were analyzed through ANOVA. The data followed normal distribution, and were compared via t-test.

RESULTSCompared with the control groups, the expression of integrin beta3 was higher in the experimental groupin tension sides (P < 0.01). Significant differences in tension sides between the single-injection groups and the combined group were observed (P < 0.01). Compared with the control groups, the expression of integrin beta3 was higher in the experimental group in compression sides (P < 0.05). In addition, there was no significant differences in compression sides between the single-injection groups and the combined group (P > 0.05).

CONCLUSIONIn terms of local regulatory factors, TGF-beta1 combined with PDGF-BB enhance the expression of integrin beta3 in the periodontal membrane and accelerate periodontal remodeling. The synergistic effect of the two growth factors is better than the single growth factor.

Chronic osteomyelitis is one of the most common disorder in clinic. In recent years due to diabetes, peripheral vascular disease and trauma induced disease increased, the prevalence rate increased. With the development of magnetic resonance imaging and CT imaging technology, it greatly improved the accuracy of clinical diagnosis of chronic osteomyclitis and ability to describe the infection characteristics, and provide a reliable basis for clinical treatment. The current research on chronic osteomyelitis mainly concentrated on the aspects of imaging applications and ways of using antibiotic optimization control inflammation, defect restoration and reconstruction of blood supply and treatment. But the best time to the antibiotic therapy and the use of program is still uncertain, for after debridement, bone grafting time and defect repair function of fast recovery still need further research.
Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Humans ; Osteomyelitis ; diagnosis ; therapy

BACKGROUND: Skin defect is commonly repaired by autologous skin graft, but in which, it is required healthy skin provider and it probably results in scarring deformity to various extents. The successful construction and clinical application of tissue-engineered skin (TE skin) mark the major breakthrough in treatment of skin defect.OBJECTIVE: To analyze the relationship between operation method and healing rate, through repair of skin defect with TE skin, to provide experimental evidence on clinical application of TE skin.DESIGN: Randomized controlled observation was designed.SETTING: Department of Oral and Maxillofacial Surgery, Teaching-Research Room of Histology and Pathology and Experimental Center of Tissue Engineering, School of Stomatology, Fourth Military Medical University of Chinese PLAMATERIALS: The experiment was performed in Experimental Center of Tissue Engineering, School of Stomatology, Fourth Military Medical University, in which 6 healthy York pigs were employed, of clean grade,aged varied from 2.5 to 3 months. 3 groups were randomized, named TE whole-layer group, TE dermal and auto-epidermal group and auto-graft group, 2 pigs in each group. 8 wounds were prepared in each pig, round in shape and 50 mm in diameter, 16 wounds in each group, totally 48wounds.METHODS: ①Preparation of TE whole layer and TE true skin. ② In TE whole-layer group: The whole layer of skin was cut off from fat layeralong the drawn line. When bleeding stopped thoroughly and the wound was covered with wet physiological saline gauze, TE whole-layer skin was collected and windowing was done on the skin for drainage. Physiological saline was used to rinsed away the culture solution on the surface of TE skin, and then, the cuticular layer was upward-covered the wound, avoiding gas vacuole between cuticular layer and wound. Single-layer oleic gauze, physiological saline gauze, aseptic dry gauze and elastic sponge cushion were covered successively, about 3-5 mm in thickness each layer. After routine dressing, elastic bandage was wrapped with compression terminally. ③ TE dermal and auto-epidermal group: The whole- layer skin was cut off with same method. Thin split-thickness skin (TIS) 0.1-0.2 mm was collected with drum dermanuring machine and soaked in physiological saline. The same method was used to collect the managed TE true skin and cover it on the wound, covering immediately on autoTTS. The rest management was same as TE whole-layer group. ④ Autograft group: The whole-layer skin was cut off and the fat tissue was removed, afterwards, it was re-grafted on the auto-wound, covered with various layers of dressing and bandaged with compression. ⑤ The survival case was determined if it was discovered no infection, necrosis and scaling of grafted skin, less than 3 mm in diameter when the wound was opened for changing fresh dressing each time, otherwise, the failed case was recorded. The survival rate in each group was analyzed statistically in 4 weeks after operation.MAIN OUTCOME MEASURES: Survival situation of grafted skin in 4weeks after operation in each group.RESULTS: In 4 weeks after operation, the survival rate of grafted skin was 75% in TE whole-layer group was 87% in TE dermal and auto-epidermal group and was 94% in auto-graft group. The results were similar basically in comparison among 3 groups (x2=-2.34, P ＞ 0.05).CONCLUSION: The effect of TE skin graft on repair of skin defect is near to that of auto-epidermal graft, testifying that the repair of skin defect with TE skin is feasible.

Objective To analyze the miss rates of colorectal adenomas during colonoscopy as well as risk factors influencing the adenoma miss rates and to take corresponding measures. Methods A total of 432 patients who underwent index and follow-up colonoscopy in 18 months were randomized and investigated. The results of two colonoscopies were compared and the missed adenomas were defined as the adenomas de-tected only during the second colonoscopy. Miss rates were calculated according to patient-based methods. Chi-square test was used to analyze the relative factors influencing the adenoma miss rate of per-patient. Then the meaningful factors were chosen into the logistic regression model for multiple factors analysis. Results Of 432 patients,116(26. 9%)had missed adenomas on first colonoscopy. Single factor analysis found that the size of adenoma( χ2 = 89. 686,P = 0. 000),the shape of adenoma( χ2 = 68. 488,P = 0. 000),the location of adenoma(χ2 = 77. 055,P = 0. 000)and adenoma tissue types(χ2 = 417. 000,P = 0. 000)were the risk factors for miss rates of colorectal adenomas. Number of polyps(χ2 = 8. 450,P= 0. 038),the organi-zation type of polyp(χ2 = 10. 718,P= 0. 013)and proficiency of colonoscopists(χ2 = 56. 069,P= 0. 000), the quality of bowel preparation(χ2 = 39. 195,P = 0. 000),insertion time(χ2 = 13. 133,P = 0. 001)were also the risk factors for miss rates of colorectal adenomas. Logistic regression analysis showed that the bigger the adenoma size,the less missed adenomas(OR= 0. 341,95%CI:0. 173-0. 671). Also,the longer insertion time took,the lower the adenoma miss rate(OR = 0. 987,95% CI:0. 981-0. 994). Per-patient miss rates were lower for high-risk adenomas compared with low-risk adenomas(OR = 0. 324,95%CI:0. 154-0. 680). Adenomas happening in multiple parts of bowel easily leads to missing(OR= 3. 791,95%CI:1. 505-9. 546). Conclusion The missed diagnosis of adenomas is not only significantly associated with features of missed adenomas,but also with skills of colonoscopists,insertion time,and bowel preparation. The key is high-quality index colonoscopy to avoid adenomas missing.

Objective To analyze the incidence,risk factors and pathogens of stroke associated pneumonia (SAP) in patients with acute stroke in the intensive care unit (ICU).Methods One hundred and forty-two patients with acute stroke admitted in ICU from January 2012 to December 2013 were retrospectively studied.The data of medical history of patients,treatment,prognosis,and pathogens of SAP were collected.Data were analyzed by t test,Mann-Whitney U test,Pearson x2 test and muhivariable logistic regression.Results Of 142 patients,94 (66.2％) were contracted SAP of which 54.3％ were early-onset pneumonia (EOP≤72 h) and 45.7％ were late-onset pneumonia (LOP ＞72 h).The most common pathogens isolated from EOP were Staphylococcus aureus and Klebsiella pneumonia,while the most common pathogens isolated from LOP were Acinetobacter baumanii,Staphylococcus aureus and Pseudomonas aeruginosa.Multivariate logistic regression analysis demonstrated that hemorrhagic apoplexy,history of stroke,higher APACHE score,dysphagia,prolonged use of mechanical ventilation,prolonged stay in ICU,and hyperglycemia were the independent risk factors of SAP,and the odds ratios (OR) with 95％ confidence intervals (CI) were 10.917 (1.834-60.959),15.223 (1.947-96.969),1.607 (1.253-2.062),5.321 (1.225-26.519),1.809 (1.208-2.709),1.391 (1.085-1.783),1.534 (1.l01-2.138),respectively.While plasma albumin level was negatively associated with SAP (OR =0.809,95％ CI:0.674-0.971).The common risk factors of EOP and LOP were higher APACHE score and prolonged use of of mechanical ventilation.The independent risk factors of EOP were dysphagia (OR =4.331,95％ CI:1.330-14.098),history of stroke (OR =13.690,95％ CI:2.198-85.277) and chronic bronchitis (OR =12.907,95％ CI:1.203-138.542),While those of LOP were prolonged stay in ICU (OR =1.687,95 ％ CI:1.131-2.517),hemorrhagic apoplexy (OR =21.657,95％ CI:1.559-106.752) and low plasma albumin level (OR =0.782,95％ CI:0.637-0.961).There was no significant difference in mortality between EOP (49％) and LOP (44.2％) (P ＞ 0.05),but the mortality of SAP was significantly higher than that of non-SAP group.Conclusions The incidence rate and mortality of SAP are quite high in ICU.The pathogens and risk factors are different between EOP and LOP.This observation results suggest it is important to identify high-risk stroke patients,and to develop a novel treatment strategy and prophylactic measures facilitating limiting the complications of stroke.