Objective To explore the clinical diagnostic value of 18 F-FDG PET/CT in patients with kidney neoplasms.Methods Seventy-nine patients (52 males,27 females,average age (57.3 ± 14.1) years),who had definitive diagnosis of kidney neoplasms by 18F-FDG PET/CT and pathological or clinical comprehensive diagnosis in recent five years,were analyzed retrospectively.The diagnosis by PET/CT was made according to the changes of kidney shape,tumor density and FDG uptake (SUVmax).The diagnostic efficacy was calculated.Results Among the 79 patients,70 cases were finally diagnosed as malignant tumors (including 40 cases of renal cell carcinoma,5 cases of renal pelvis carcinoma,8 cases of lymphoma,16 cases of metastatic tumor,and 1 case of renal fascia capsule liposarcoma) and 9 cases of benign tumors (including 7 cases of angiomyolipomas,1 case of renal acidophilic cell adenoma,1 case of metanephric adenoma; the benign tumors did not contain small lipid sample hamartoma cases).The detective rate of kidney neoplasms with 18F-FDG PET/CT was 97.5％ (77/79).For the identification of benign and malignant lesions,the sensitivity of 18F-FDG PET/CT was 92.9％ (65/70),specificity was 7/9,accuracy was 91.1％ (72/79),positive predictive value was 97.0％ (65/67),and negative predictive value was 58.3 ％ (7/12).Conclusions 18 F-FDG PET/CT can detect and identify most of kidney tumors.Whole-body checking and comprehensive evaluation on kidney cancer patients are still the main advantages of PET/CT.

Objective To investigate the clinical efficacy of laparoscopic hepatectomy.Methods The clinical data of 258 patients who received laparoscopic hepatectomy at the First Affiliated Hospital of Fujian Medical University from March 2010 to January 2013 were retrospectively analyzed.There were 196 patients with primary hepatic cancer,45 with hepatic hemangioma,13 with hepatic focal nodular hyperplasia,2 with hepatic metastatic cancer,1 with carcinoma of gallbladder and 1 with hepatic hamartoma.All patients were followed up via phone call or out-patient examination till March 2013.Results A total of 142 patients received single hepatic segmentectomy,98 received multiple hepatic segmentectomy,18 received multiple lesions resection.Fifty-one patients received hepatic tumorectomy + cholecystectomy.All the operations were successfully done under laparoscope without conversion to the open surgery.The mean tumor diameter and the operation time were (5 ± 3) cm (range,1.0-11.5 cm) and (113 ± 56) minutes (range,50-310 minutes),respectively.Intraoperative hepatic portal occlusion was performed on 122 patients,and the time for hepatic portal occlusion was (15 ± 7)minutes.The volume of intraoperative blood loss was (211 ± 195)mL (range,10-650 mL),and blood transfusion was not needed.The capsule of the tumor was complete.The distance between the resection margin and the malignant tumor was above 1.5 cm,and there was no residual tumor in the resection margin.The hepatic function was back to the normal level in 1 week after the operation,and no patient had hepatic failure.The duration of postoperative hospital stay was (7.2 ± 1.3)days (range,5-10 days).One patient was complicated with bile leakage,6 with slight peritoneal effusion,and other patients had no postoperative complications.The rate of follow-up was 91.47％ (236/258),and the time of follow-up was (16 ± 10) months.A total of 199 patients with malignant hepatic tumors were followed up.During the follow-up,180 patients had tumor-free survival; 18 patients had postoperative tumor recurrence; 1 patient had omental metastasis and received surgical resection.Thirty-seven patients with benign hepatic tumor survived without complication during the follow-up.Conclusion Laparoscopic hepatectomy is effective for the treatment of hepatic tumors.Multiple hepatic inflow occlusion under laparoscope in a short time may improve the safety of surgery,without prolonging the recovery time of patients.

Objective To study the methylation of CpG motifs and expression of lymphocyte function-associated antigen-1 (LFA-1) mRNA in patients with systemic lupus erythematosus (SLE), and evaluate their associations. Methods The peripheral blood lymphocytes were collected from 26 patients with SLE and 17 normal individuals. The methylation of CpG motifs was detected by the 5-methylcytosine antibody and flow eytometry, and the expression of LFA-1 mRNA was analyzed by RT-PCR. Results Methylation of CpG motifs in patients with SLE was lower than the control subjects (P<0.05), and a negative correlation existed between methylation of CpG motifs and SLEDAI (P<0.05). While expression of LFA-1 mRNA in patients with SLE was higher than that in the control group (P<0.05), and a positive correlation could be detected between the expression of LFA-1 mRNA and SLEDAI (P<0.05). There was a negative correlation between methylation of CpG motifs and expression of LFA-1 mRNA (P<0.05) in patients with SLE. Conclusion Hypomethylation of CpG motifs does exist in patients with SI,E, and is correlated with high expression of LFA-1, therefore, epige-netics plays an important role in the pathogenesis of SLE.

Objective To investigate the effects of 5-azacytidine and estradiol on the methylation of CpG motifs and expression of DNA methyltransferasel (DNMT1) mRNA in patients with systemic lupus erythematosus (SLE) and normal controls.Methods Peripheral blood lymphocytes isolated from 12 patients with SLE and 11 normal human controls were stimulated with phytohaemagglutinin for one day followed by additional 3-day culture with or without the presence of 5-azacytidine of 1 μmol/L or estradiol of 30μg/L respectively.Then.the methylation of CpG motifs was detected by flow cytometry using anti-5-methylcytosine antibody,and DNMT1 mRNA expression by real time reverse transcription-PCR Results After treatment with 5-azacytidine,a decrease wag observed in the methylation of CpG motifs, but not in the expression of DNMT1 mRNA in peripheral lymphocytes from patients with SLE (1=18.60,P<0.01;t=1.56.P>0.05) and in those from the normal controls (t=5.63,P<0.01;t=2.17,P>0.05) compared with untreated lymphocytes.Nevertheless,there were no significant changes in the methylation of CpG motifs or expression of DNMT1 mRNA in lymphocytes from patients with SLE (t=1.53,0.93,respectively,both P>0.05) and normal controls (t=1.93,0.11,respectively,both P>0.05) after the treatment with estradiol.Conclusions The methylation of CpG motifs is suppressed efficiently by 5-azacytidine,and the suppression is unlikely to be associated with the decrease of DNMT1 mRNA.Estradiol has no significant impact on the methylation of CpG motifs and expression of DNMT1 mRNA in lymphocytes.

Owing to medical students'joining in, the correlation between doctors and patients have expanded into the relationship between doctors and medical students and patients in clinical teaching of sexually transmitted disease ( STD). It is easy to disobey ethical principle and lead to medical dispute happened if not be cautious to deal with the relationship. So we present that ① strictly to following medical ethical principle; ② establishing a harmonious doctor - patient relationship; ③improveing teaching ways to a rational extent in medical treatment of medical students were concerned with patients, and disposing the relationship between " Teaching" and " Learning" ; ④enhancing the professional morality culture of doctors( clinical teachers) and medical students, and providing the high quality service for patients. Thus ethical problems can be avoided effectively in clinical teaching of STD, and clinical teaching can be ensured go on wheels effectively too.

Objective Based on the result of evaluating the nutritional state of in-patients using the methodologies of European Nutritional Risk Screening 2002(NRS 2002),we judged the rationality of nutritional therapy,and the rate of accepting nutritional therapy in hospital patients.Methods Totally 3567 inpatients consisted with the requirement of NRS2002 were investigated nutritional state and the situation of nutritional therapy within 2 weeks in hospital.Except BMI used as the standard of China,all the other methods were from NRS2002.Nutritional therapy included parenteral and enteral nutrition.Results In all objects,834 patients' number score was≥3(23.39%),and 256 got nutritional therapy among them(30.70%).The number of accepting nutritional therapy was 661(18.53%),and only 38.73% of them had a patient number score≥3.Conclusion NRS2002 is a good method to evaluate the nutritional state of in patients.The nutritional therapy should be on the basis of patient's nutritional state,but there isn't one specification in clinical nutrition-support.Many malnourished patients were ignored,while a lot of nutritional therapies were not suitable.Now one of method to solve this question is to set up Nutrition Support Team(NST).

Objective To investigate the application of dual volume reconstruction translucent imaging in performing stent- assisted coil embolization for intracranial aneurysm embolization treatment. Methods During the period from Nov. 2011 to Sep. 2012, a total of 30 patients with intracranial aneurysm were admitted to authors’ hospital. Stent-assisted coil embolization was carried out in all patients. The number of all the stent point-marks visualized on routine 2D-DSA, on rotational angiography (3D-RA) and on dual volume reconstruction translucent images were determined, and the results were compared between each other of the three imaging methods. Results A total of 34 stents (206 stent point-marks in total) were implanted in the 30 patients. Of the 206 stent point-marks, 2D-DSA, 3D-RA and dual volume reconstruction translucent image could clearly display 146 (70.8%), 123 (59.7%) and 190 (92.2%), respectively. Statistically significant difference in the displaying rate of the stent point-marks existed between each other among the three imaging methods (P < 0.05). Conclusion Dual volume reconstruction translucent imaging can distinctly display the location of the stent marks, which is of great value in guiding the performance of intracranial stent implantation surgery.

Objective To study the effect of small interfering RNA targeted on Apollon for proliferation on pancreatic cancer cells and its possible acting mechanism.Methods The small interfering RNA targeted on apollon in our previous study was transfected to the cells using LipofectamineTM 2000,after 48 hours transtection.The inhibitory effects of small interfering RNA targeted on Apollon (Apollon siRNA)on cell proliferation were detected by WST-8.Their inhibition rate and IC50 were calculated.The percentage of apoptosis cells were determined by flow cytometry.The expression of Apollon mRNA was analyzed by real time fluorescent quantitative reverse transcription polymerase chain reaction.The Apollon protein ex-pression levels were detected by western blotting.Results Apollon siRNA could effectively inhibit the proliferation of pan-creatic cancer cell.The amount of apoptotic cells increased significantly.The early apoptotic rate was 37.1%,and the RT-PCR results showed that the relative expression levels of Apollon mRNA were down-regulate,and shows a dose-effective-ness relations.The protein expression levels were decreased by Apollon siRNA.Conclusion Apollon siRNA can effectively inhibit the proliferation of pancreatic cancer cell.The mechanism may be work together to promote pancreative cancer cell early apoptosis and decreased the expression levels of gene and protein,which provides a novel potential approach for treat-ment of target therapy of pancreatic cancer.

Objective To analyse the relationship between T lymphocyte subsets and NK cells expression and dynamic changes in lung cancer patients 'peripheral blood and the occurrence and development of cancer,and investigate their clinical significances.Methods Flow cytometry was applied to detect 66 patients with lung cancer,60 patients with pulmonary tuberculosis and 60 healthy persons peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression.Lung cancer group peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression were also detected on 3rd,7th and 20th day before and after chemotherapy.Results Lung cancer group CD+3,CD+3CD+4,Th/Ts,CD+16CD+56 expression decreased significantly [(54.23±10.37)％,(34.23±8.03)％,1.35±0.20,(25.18±4.34)％] and had significant differences compared with pulmonary tuberculosis group [(63.09±9.19)％,(39.46±12.74)％,1.51±0.41,(26.45±3.96)％] and healthy group [(69.68±8.31)％,(42.31±13.29)％,1.89±0.48,(29.44±2.51)％](P ＜ 0.05),but CD+3CD+8 expression showed no significant difference(P ＞ 0.05).In chemotherapy group,comparing with before chemotherapy,remission group CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression decreased significantly (P ＜ 0.01)on 3rd day after chemotherapy,while CD+3CD+8expression increased significantly(P ＜ 0.01).On 7th day,each index recovered to the level of before chemotherapy basically.On 20th day,CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression increased significantly(P ＜ 0.05)compared with before chemotherapy,while CD+3CD+8 expression significantly decreased(P ＜ 0.05).Chemotherapy unease group had no significant difference (P ＞ 0.05).Lung cancer of stage Ⅲ A and Ⅲ B compared with stage Ⅰ A,and lymph node metastasis in N3 group compared with N0 group,CD+3,CD+3CD+4,CD+3CD+8,Th/Ts and CD+16CD+56 expression had significant differences (P ＜ 0.05).Compared with their pathological types,each index had no significant difference(P ＞ 0.05).Conclusion Monitoring the peripheral blood T lymphocyte subsets and NK cells dynamic of lung cancer patients can guide the clinical diagnosis and treatment,and contribute to the assessment of immune function.

Objective To investigate the value of 18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin.Methods Seventy-eight patients (48 males,30 females,average age (56.4± 14.7) years) who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent 18F-FDG PET/CT from 2007 to 2012.ROI was drawn with SUVm~ calculated.The distribution of the lymph nodes was classified according to the standard levels Ⅰ to Ⅵ,as well as the retropharyngeal and supraclavicular stations.The short axis of lymph node was defined as the lesion size.The final diagnosis was confirmed by pathology and clinical follow-up.Data collection and interpretation included identification of primary malignancy,pathologic types of primary tumors,distribution,size and SUVmax of the metastatic lymph nodes.One-way analysis of variance and linear correlation analysis were used for data analysis.Results In 78 subjects,75 were diagnosed as having malignant and 3 as benign lymph nodes by excisional biopsy.18F-FDG PET/CT detected primary malignancy in 56 cases (71.8％,56/78).In these 56 cases,57.1％(32/56) had head and neck cancer with metastatic lymph nodes mainly distributed in levels Ⅱ,Ⅲ and Ⅳ (90.6％,29/32).The remaining 24/56 (42.9％) patients had primary malignancy of the trunk with metastatic lymph nodes primarily involving supraclavicular fossa (95.8％,23/24).There was no statistical difference in size and SUVmax of lymph node among different primary locations or pathological types (F=0.037-2.413,all P＞0.05).Conclusion 18FFDG PET/CT may play an important role in the detection of primary cancers for patients with metastatic cervical lymph nodes from unknown origin.