Objective The sensitivity and specificity of 18 FDG PET/CT are poor in the diagnosis of gastric cancer .Gastric signet ring cell carcinoma and Mucinous gastric carcinoma is known to have low fluorodeoxyglucose (18FDG) uptake,but not known for poorly differentiated gastric adenocarcinoma .This study was to investigate the value of 18 FDG PET/CT in the diagnosis of poorly differ-entiated gastric adenocarcinoma . Methods We retrospectively analyzed the results of 18 FDG PET/CT of 34 cases of histologically confirmed poorly differentiated gastric adenocarcinoma .We recorded the volume , location , and gastric wall invasion depth , and maxi-mum standardized uptake value ( SUVmax) of the tumors and analyzed the relationship of 18 FDG uptake with the clinicopathologic pa-rameters. Results By 18 FDG-PET/CT, poorly differentiated gastric adenocarcinoma was diagnosed in only 67.6% of the patients (23/34).SUVmax was found to be significantly correlated with age , gastric wall invasion, and tumor size (P<0.05), but not with gender , tumor location , tumor pathologic subtype , lymph node metastasis , and distant metastasis ( P>0 .05 ) .Logistic regression a-nalysis showed the tumor size to be the sole factor influencing the 18 FDG uptake of poorly differentiated gastric adenocarcinoma ( OR=0.37, 95%CI 0.154-0.920, P=0.03). Conclusion The di-agnostic value of 18 FDG-PET/CT is but limited for poorly differentia-ted gastric adenocarcinoma , and attention should be paid to its false-negative results .

Background Proliferative diabetic retinopathy (PDR) is a serious complication of diabetes mellitus,and vitrectomy is a main treatment.Exploring the influential factors of blood glucose fluctuation during perioperative duration is helpful for surgery.Objective The aim of this study was to explore glycolic fluctuation and its influential factors in PDR patients.Methods A retrospective cases-observational study was carried out.The clinical data of 100 PDR patients who received vitrectomy in Peking University People's Hospital from March to August in 2013 were collected,including 8 cases with type 1 diabetes mellitus and 92 cases with type 2 diabetes mellitus.The PDR patients were staged as Ⅳ,Ⅴ,Ⅵ based on the criteria of The First National Fudus Conference.The body height,weight,history of hypertension,PDR stage,previous usage of insulin,glycosylated hemoglobin (HbA1c) level,admission blood pressure,blood glucose level in different time points and postoperative body positions were recorded,and perioperative anxiety was scored according to the Hamilton Anxiety Scale (HAMA).Repeated ANOVA was used to analyze blood glucose and anxiety at different time points.Results The linear regression analysis showed that the preoperative blood glucose level was lower in the patients who used insulin during perioperative period(r =-1.64,P＜0.05).HbA1 c level showed the positive correlations with the blood glucose level at different time points(all at P＜0.05).The waiting time for surgery had a positive correlation with the fasting blood glucose in the morning of operative day(r=0.54,P＜0.05),and the postoperative position primarily caused the raise of postoperative right blood glucose(r =1.10,P＜0.05).The anxiety score on admission presented with the positive correlations with the blood glucose levels at admission and 2 hours after breakfast,lunch and dinner on the first postoperative day (r=0.13,0.07,0.05,0.10,all at P ＜ 0.05),and the high anxiety scores at preoperation and postoperation induced the high blood glucose levels at the corresponding time points (r =0.14,0.16,both at P＜0.05).A positive correlation was found between the anxiety score and blood glucose fluctuation values (ρ=0.47,P＜0.01).The blood glucose values were significantly lower in the patients with normal HbA1c than those with high HbA1c (all at P ＜ 0.05).Conclusions Remaining an ideal HbA1c level,establishing a good doctor-patient relationship and administering appropriate sedative drugs can ease the anxiety and improve the glycolic of PDR patients during preoperative duration.

Cancer, a group of various diseases involving unregulated cell growth, still imposes a global threat to public health. Ginseng plants, which contains a wide variety of saponins, known as ginsenosides, is an age-old remedy for human ailments, including cancer.This review sheds light on the molecular mechanisms underlying the cancer chemopreventive and/or chemotherapeutic activity of ginsenosides and their metabolites with particular focus on the modulation of cell signaling pathways associated with cell proliferation, apoptosis, angiogenesis, oxidative stress, inflammation and the metastasis of cancer cells.The review could enhance the understanding of the anticancer mechanisms of ginsenosides, provide directions for clinical practice and give more information for developing novel an-ticancer agents with high efficiency, low toxicity and weak resistance.

Objective To evaluate the efficacy of balloon dilatation in the treatment of intrahepatic biliary strictures in patients with liver transplantation. Methods Of the 100 patients with liver transplantation, 16 patients had intrahepatic biliary strictures and received balloon dilatation treatment. Results Initial technical balloon dilatation was successful in 14 cases but failed in 2 cases. There were no procedure-related complications. 4 restenosis occurred and they were treated with repeated balloon dilatation treatment. Conclusion Balloon dilatation represented an effective and relatively safe treatment for biliary stricture in liver transplant recipients. For restenosis, balloon dilatation was also an effective treatment.

Objective To analyze the value of predict lymph node status according to the tumor size, solid size, and maximum standardized uptake value(SUVmax) in adenocarcinoma of the lung with a size of ≤3 cm. Methods One hundred and thirty-six patients who had undergone curative resection for lung adenocarcinoma were enrolled in this retrospective study.The largest transverse sectional diameter of the tumor and solid size were measured. Then SUVmax of the main tumor was assessed. Logistic regression analysis was performed by taking the lymph node status as the dependent variable,and the size of solid component of tumor, SUVmax were taken as independent variables. The predicted probability of the Logistic regression model was enrolled in receiver operating characteristic analysis.Results Among the 136 cases of lung adenocarcinoma, the incidence of lymph node metastasis was 24.3%(33/136). Logistic regression analysis showed that the size of the solid component (OR 3.880, 95%CI 1.788 to 8.421, P<0.05) and SUVmax (OR 1.179, 95%CI 1.024 to 1.357, P<0.05) at baseline predicted the metastasis of lymph node independently. And the size of tumor was non-independent predict factor (OR 1.238, 95%CI 0.360-4.260, P>0.05). The ROC curve analysis was performed based on the predicted probability of Logistic regression model, and the area under the curve was 0.838(P<0.01) Conclusions Solid size and SUVmax are important predictors for lymph node metastasis of lung adenocarcinoma with a size of ≤3 cm, and it may be helpful to avoid unnecessary limited resection or lymph node dissection.

Objective To study the intra-and extra-hepatic collateral pathways in various types of Budd-Chiari syndrome (BCS) using liver acceleration volume acquisition (LAVA) enhanced MRI.Methods The clinical data and imaging findings of 240 patients with BCS were collected and analyzed.The types of BCS confirmed by DSA.Intra-and extra-hepatic collateral pathways were studied using LAVA enhanced MRI with a 3.0T scanner.Correlations of the intra-/extra-hepatic collateral pathways with the types of BCS were analyzed using the Chi-square test.Then,the degrees of correlation were calculated by the Cramet correction coefficient of contingency.Results Among the 240 patients,DSA confirmed 60 patients to have hepatic vein occlusion,39 patients to have inferior vena cava occlusion and 141 patients to have both hepatic vein and inferior vena cava occlusion.MRI demonstrated dilated accessory hepatic veins in 157 patients,intra-hepatic communicating branches in 69 patients,inferior phrenic veins in 43 patients,superficial epigastric veins in 135 patients,umbilical veins in 94 patients and hemiazygos/azygos veins in 195 patients.Accessory hepatic veins and hemiazygos/azygos veins as collateral pathways were associated with the types of BCS (x2 =30.239,P ＜ 0.05;x2 =51.295,P ＜ 0.05,respectively).The degrees of correction were 0.355 and 0.462,respectively.Accessory hepatic veins as collateral pathways were most common in the mix type,accounting for 79.4％.Hemiazygos/azygos veins were most common in the inferior vena cava occlusion type and the mix type,accounting for 92.3％ and 91.5 ％,respectively.Conclusions Accessory hepatic veins and hemiazygos/azygos veins as collateral pathways were associated with the types of BCS,while the intra-hepatic communicating branches,inferior phrenic veins,superficial epigastric veins and umbilical veins were not correlated with the types of BCS.LAVA may help to diagnose and determine the best choice of treatment for the various types of BCS.

OBJECTIVE:To investigate the effect of different doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy. METHODS:60 patients in perioperative thoracotomy were randomly divided into control group(30 cas-es)and observation group(30 cases). Control group received 30 mg Ambroxol hydrochloride injection from 1 week before surgery to 1 week after surgery,adding into 100 ml 0.9% Sodium chloride injection,intravenously,twice a day. Observation group re-ceived 300 mg Ambroxol hydrochloride injection from preoperative 1 week to postoperative 1 week,adding into 100 ml 0.9%Sodi-um chloride injection,intravenously,twice a day. All patients received the second-generation cephalosporin antimicrobial drugs for anti-infection after surgery. lung surfactant-associated protein A(SP-A),intercellular adhesion molecule(ICAM-1)levels preopera-tive 1 week and postoperative 1 week,and incidence of postoperative complications in 2 groups were observed. RESULTS:Preop-erative 1 week,there were no significant differences in the SP-A and ICAM-1 in 2 groups(P>0.05). Postoperative 1 week,SP-A and ICAM-1 in control group and ICAM-1 in observation group were significantly higher than preoperative 1 week,but SP-A and ICAM-1 in observation group were lower than control group,the differences were statistically significant(P<0.05),there were no significant differences in SP-A in preoperative 1 week and postoperative 1 week(P>0.05). The incidence of postoperative compli-cations in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CON-CLUSIONS:The effect of high-doses ambroxol hydrochloride on lung protection of patients in perioperative thoracotomy is signifi-cantly superior to small dose,which can reduce the incidence of lung complications.

Objective Study the diagnostic value of CT to assess the transfer of right recurrent nerve nodes(RRNN) on the thoracic esophageal squamous carcinoma,so as to provide reference for thoracic segment esophageal surgery way.Methods A retrospective analysis from January 2011 to February 2014 in the first affiliated hospital of zhengzhou university at the records of 132 cases of thoracic segment esophageal thoracic surgery with preoperative CT image data,recorded each patient's right recurrent nerve nodes in the largest length to diameter and the average CT number,and compared with postoperative pathologic results.Results With the ROC curve analysis,considering transfer when the length of RRNN' s diameter 8.5 mm or more in CT,the area under the curve is 0.911,the sensitivity is 85.7％,specificity is 78.8％.Considering transfer when the RRNN average CT number acuity 32.50 HU,the area under the curve is 0.815,the sensitivity is 85.7％,specificity is 76.9％.Whether RRNN transfer has significant correlation(P ＜ 0.05) with the length of tumor,tumor location and whether lymph node of other station transfer,doesn' t have significant correlation (P ＞ 0.05)with patients'age,sex,tumor differentiation degree and the T stage.Conclusion When the RRNN length to diameter 8.5 mm or RRNN average CT numberr acuity 32.50 HU,right recurrent nerve nodes should be considered lymph node metastasis,and choose chest conclusion laparoscopic radical prostatectomy.The upper thoracic portion esophageal tumor's length is 5 cm or more,or clinical suspected lymph node metastasis of other station is the risk factor for metastasis of RRNN.

BACKGROUND:Simple spinal decompression for lumbar degeneration-induced lumbar scoliosis spinal stenosis is difficult to obtain long-term efficacy. Because simple decompression is considered an iatrogenic lumbar instability, and can aggravate lumbar deformity. Posterior lumbar pedicle screw fixation combined with decompression and fusion obtained good curative effects in patients.
OBJECTIVE:To investigate the clinical efficacy of posterior decompression, internal fixation, and bone graft fusion with posterior pedicle screw system in the treatment of degenerative lumbar scoliosis with stenosis.
METHODA retrospective analysis was performed in 18 patients with degenerative lumbar scoliosis with stenosis who received surgical treatment from February 2009 to November 2012. These patients consisted of 6 males and 12 females, with a mean age of 62.2 years (range, 48-80 years). They had lumbar scoliosis with a mean Cobb angle of 28.6° and underwent posterior decompression, internal fixation, and bone graft fusion.
RESULTS AND CONCLUSION:Al the 18 patients achieved satisfactory fol ow-up. The mean fol ow-up was 22 months. Al patients were satisfied with treatment outcomes and had improved quality of life. The mean correction angle was 13.7° (range, 6.0°-28.4°) after operation. There was no failure of internal fixation, and no infected cases were found. These data inducated that posterior decompression, internal fixation, and bone graft fusion is one of the effective methods for treating degenerative lumbar scoliosis with stenosis.

Objective To observe the effect of the application of peripherally inserted central catheter (PICC) network platform in the information management of the patients with PICC.Methods Altogether 17 254 outpatients receiving PICC maintenance in Peking Union Medical College Hospital from April 2012 to April 2013 were enrolled as the control group,including 7 227 males and 10 027 females,with the median age of 58 years (12-85 years).A total of 20 384 outpatients from April 2013 to April 2014 with PICC were selected as the observation group,including 8 188 males and 12 196 females,~th the median age of 59 years (13-86 years).Those patients all received PICC maintenance in outpatient clinic during the intermission of therapy after PICC insertion.The time of data entry,the integrity of the data,description accuracy about complications,and normalization of wording were compared between the two groups.Results The average time of data entry in the control group was (46 ± 6) seconds,significantly longer than that in the observation group [(12 ± 5) seconds,t =562.660,P ＜ 0.05].In terms of the integrity of the data,there were 11 732 cases of complete data,3 623 cases of less complete data,and 1 899 cases of incomplete data in the control group;while the numbers of cases of complete data,less complete data,and incomplete data in the observation group were 19 568,725,and 91,respectively,showing significant difference compared with the control group (x2 =5 312.000,P ＜ 0.05).In the description accuracy about complications,the control group had 11 840 accurately described cases and 5 414 inaccurately described cases,while the observation group had 18 427 accurately described cases and 1 957 inaccurately described cases (x2 =2 814.000,P ＜ 0.05).The wording was standard in 15 280 cases but not standard in 1 974 cases in the control group,and standard in 19 659 cases and not standard in 725 cases in the observation group,with significant inter-group difference (x2 =872.600,P ＜0.05).Conclusion Simple and convenient data summary could help quality control and quality analysis,preferably guarantee the safety of catheter insertion and reduce the incidence of complications.