Objective To compare the efficiency of 18F-FDG PET/CT and contrast enhanced ultrasound (CEUS) in detection of HCC recurrence after surgery or radiofrequency ablation (RFA).Methods Twenty-seven HCC patients (22 males,5 females; average age:47 years) were included in this study,of which 15 patients underwent surgery and 12 patients underwent RFA therapy.18F-FDG PET/CT and CEUS were performed within 2 weeks in all patients to detect recurrence.Final diagnosis was made by pathology or clinical follow-up (＞6 months),and the sensitivity,specificity and accuracy of 18F-FDG PET/CT and CEUS were calculated and compared.McNemar test was used for data analysis.Results Twenty-five patients were diagnosed with HCC recurrence,including 11 cases with extrahepatic metastases.Another 2 patients had extrahepatic metastases without HCC recurrences.The sensitivity,specificity and accuracy in detection of liver lesion with 18F-FDG PET/CT were 92.0％ (23/25),2/2 and 92.6％ (25/27),respectively.While with CEUS,the corresponding values were 60.0％ (15/25),2/2 and 63.0％ (17/27),respectively.In CEUS positive group,the sensitivity and accuracy were 100％(15/15) for both methods.In CEUS negative group,the sensitivity,specificity and accuracy of 18 F-FDG PET/CT in detection of liver lesion were 8/10,2/2 and 83.3％(10/12),respectively.The sensitivity and accuracy of 18F-FDG PET/CT were significantly higher than those of CEUS (0,16.7％(2/12) ; x2 =5.373,5.250,both P＜0.05).Moreover,the sensitivity of 18 F-FDG PET/CT in detecting extrahepatic metastasis was 100％ (13/13).Conclusions 18 F-FDG PET/CT is more sensitive and accurate than CEUS (especially in CEUS negative cases) in detecting recurrence of HCC after surgery or RFA.18F-FDG PET/CT also could be useful for detection of extrahepatic metastasis.

Objective To evaluate the diagnostic value of three nuclide imaging methods in patients with hyperparathyroidism. Methods Thirty five patients with hyperparathyroidism underwent 201 Tl/ 99m TcO-4 (8 cases), double phase 99m Tc MIBI imaging methods (27 cases) and 99m Tc MIBI/ 99m TcO-4 substraction imaging (20 cases). Abnormal increase of radioactivity in substraction imaging or delay imaging denoted positive result. All data of nuclide imaging were evaluated according to final clinical results and were compared with ultrasound or CT. Results 35 cases of hyperparathyroidism were proved, including 31 adenomas (ectopic 1), 3 hyperplasia and 1 carcinoma. The sensitivity of 201 Tl/ 99m TcO-4 , double phase 99m Tc MIBI imaging and 99m Tc MIBI/ 99m TcO-4 substraction imaging was 62.5%, 88.9%,90.0%, respectively. The specificity of 3 nuclide imaging methods was 100%. The sensitivity and specificity of ultrasound were 74.3%, 85.7%, respectively. The sensitivity of CT was 78.6%. The results showed that 99m Tc MIBI/ 99m TcO-4 was superior to other imaging. Conclusion An accurate diagnosis of hyperparathyroidism and preoperative anatomic localization can be determined by means of nuclide imaging.

Objective To understand the e ff ectiveness of parasite ova sediment and non-hazardous treatment of two-grille la trines. Methods Two-grille latrines were recon n oitered in the field according to the non-hazardous treatment criteria, and th e sediment of parasite ova, the value of fecal coliform bacteria, NH 3-N, CODcr of the samples from the Grille 1 and Grille 2 of latrines were detected.Results The structure of some two-grille latrines was n o t in accord with the non-hazardous treatment criteria.Parasite ova were detecte d from the Grille 2 of one latrine. Six of 16 latrines were not eligible for non -ha zardous treatment according to the value of fecal coliform bacteria in Grille 2. Conclusion It is not suggested to popularize th e two-grille latrine yet, but it can be used as an interim form for excrement n on-hazardous treatment in rural areas. [

Objective To develop two-grille latrines with the effect of non-hazardous treatment. Methods According to the result of the pretest, one type of two-grille latrines was selected and constructed and its effect of non-hazardous treatment was evaluated. Results The faces-treatment pool, with cement-prefab structure and obturation, had a total cubage of 1.32 m3. The average total amount of faces in the pool was 1.05 m3 per family per month, and the pool could store the faces for over 34 days. The “reaching criteria rate” of the parasite ova sediment and the value of the fecal coliform bacteria were 100% among the excrement in the outlet. Conclusions The prefab two-grille latrines can reach the criteria of non-hazardous treatment, and they can be used in well-off rural areas without the usage of manure.

Objective To investigate the usefulness of 13N-NH3 PET in detecting brain lesions which show hypometabolism on 18F-FDG PET.Methods 13N-NH3 PET imaging was performed for a prospective study in 18 patients with brain lesions that showed hypometabolism compared with normal brain tissue on 18F-FDG PET scans.Fourteen patients underwent 18 F-FDG PET imaging for initial diagnosis and 4 patients for detection of astrocytoma recurrence (13 males,5 females,age 20-68 (42.4 ± 12.6) years).Ten gliomas,1 metastatic tumor,1 dysembryoplastic neuroepithelial tumor (DNT) and 6 non-neoplastic lesions (including 3 cases of radiation necrosis,2 cases of encephalitic foci,and 1 case of ischemic lesion)were verified by histopathological examination (n =13) or clinical follow-up (n =5).The tumor-to-contralateral brain tissue ratios (T/C) were calculated by the ROI method.The diagnostic efficacy of 13N-NH3 PET was evaluated.Paired t test and two-sample t test were performed to analyze the differences of T/C between different groups.Results Seven (5 astrocytomas and 2 glioblastomas) of 12 brain tumors (sensitivity:58％,7/12) showed increased 13N-NH3 uptake (higher uptake than the contralateral brain tissue),while 3 low-grade gliomas,1 metastatic tumor,and 1 DNT showed decreased 13N-NH3 uptake (no uptake or lower uptake than the contralateral brain tissue).The uptake ratio of 13N-NH3 was significantly higher than that of 18 F-FDG (1.24 ± 0.66 vs 0.67 ± 0.24,t =-3.740,P ＜ 0.05) in the tumors.All six non-neoplastic lesions showed decreased 13N-NH3 uptake (specificity:6/6).The T/C ratios of 18F-FDG and 13N-NH3 in the non-neoplastic lesions were 0.68 ±0.15 and 0.70 ±0.19,respectively,and there was no significant difference between them (t =-0.246,P ＞ 0.05).The T/C ratio of 13N-NH3 in the tumors was significantly higher than that in the non-neoplastic lesions (1.24 ± 0.53 vs 0.70 ± 0.19,t =2.624,P ＜ 0.05).Conclusion 13N-NH3 PET imaging may be helpful to detect and differentiate brain tumors with hypometabolism as detected by 18 F-FDG PET imaging from non-neoplastic lesions with high specificity,especially for cerebral astrocytomas,but the sensitivity is relatively limited.

Objective To explore the clinical value of ω-3 fatty acids (ω-3PUFA)immune nutrition therapy for the patients with acute ischemic stroke,and analyze its mechanism.Methods 40 patients with acute ischemic stroke were selected.They were divided into the treatment group and the control group,each group in 20 cases. The patients of the control group were given indwelling tube admitted to hospital within 24 hours,given the homogenized meal configured by nutriology department.The treatment group received ω-3PUFA enteral nutrition based on the control group.The neurologic recovery,nutritional status,lipid levels and the incidence of complications were evalua-ted.Results The total effective rate of the treatment group was 90.0%,which was higher than that of the control group (60.0%,χ2 =4.8,P <0.05).The incidence rate of complication of the treatment group was 30.0%,which was lower than the control group (65.0%,χ2 =4.91,P <0.05).The indicators such as NIHSS score,GCS score, TSF and AMC in the treatment group were better than those in the control group[(13.38 ±1.21)points vs.(10.12 ± 1.33)points;(12.9 ±2.6)points vs.(14.1 ±1.7)points;(14.06 ±7.16)mm vs.(14.8 ±4.18)mm;(26.32 ± 1.42)mm vs.(29.40 ±1.08)mm,t =3.51,6.44,3.22,5.19;all P <0.05].TG and LDL -C in the treatment group were lower than those in the control group[(1.60 ±0.71)mmol/L vs.(1.41 ±0.67)mmol/L;(3.11 ±0.60)mmol/L vs.(2.67 ±0.66)mmol/L,t =5.97,4.22;all P <0.05 ].Conclusion The clinical curative effect is better for application of ω-3PUFA on immune nutrition treatment for the patients with acute ischemic stroke.The patients'nerve function,blood lipid levels and nutritional status were significantly improved,and the complications were reduced.

[Objective]This study was conducted to examine the effects of dexmedetomidine on the proliferation and angiogenesis of MHCC97H and SMCC7721 human hepatocellular carcinoma(HCC)cell lines cultured in hypoxia condition in vitro,and investigated the possible mechanism involved.[Methods]MHCC97H and SMCC7721 human HCC cell lines under hypoxia culture condition were treated with presence or absence of dexmedetomidine(100 μmol/L). Cell viability,colony formation,vasculogenic mimicry(VM) formation were assessed. The effects of dexmedetomidine on α-2A adrenergic receptor(α2A),hypoxia induced factor-1a(HIF-1a),and vascular endothelial growth factor(VEGF)protein expression were evaluated with Western blot analysis.[Results]Cell proliferation assay and colony formation assay indicated that hypoxia obviously promoted the proliferation of MHCC 97H and SMCC7721 cells(CoCl2 group vs corresponding control group,the proliferation rate of MHCC97H and SMCC7721:Day 3,142.2%and 133.8%;Day 4,134.7%and 131.0%;Day 5,133.5%and 136.2%;all P<0.05),and VM formation assay suggested that hypoxia increased angiogenesis of MHCC97H and SMCC7721 cells. Whereas dexmedetomidine significantly inhibited the proliferation(Dex+CoCl2 group vs CoCl2 group,the proliferation rate of MHCC97H and SMCC7721:Day 3,55.7%vs 60.7%;Day 4,46.9%vs 58.1%;Day 5,46.4%vs 57.0%,all P<0.05)and angiogenesis of MHCC97H,SMCC7721 cells induced by hypoxia. Dexmedetomidine may exert these functions by activating α-2A adrenergic receptor,causing an decrease in HIF-1a and VEGF protein,while hypoxia activated HIF-1a and VEGF protein to promote the growth and angiogenesis of cells.[Conclusion]The findings provide evidence that hypoxia could promote the proliferation and angiogenesis of MHCC97H and SMCC7721 cells,while dexmedetomidine might inhibit these effects by down-regulating HIF-1a and VEGF protein expression through activatingα-2A adrenergic receptor.

Objective To evaluate the safety and efficacy of Stretta procedure for gastro-esophageal reflux disease (GERD) based on changes of symptoms, medication and esophagitis grade. Methods A total of 90 patients with GERD who underwent Stretta procedure from June 2007 to March 2010 were followed up for 6 to 32 months. The health related quality of life of GERD ( GERD-HRQL), symptoms, medication and grade of esophagitis were evaluated at baseline, 6 and 12 months after the procedure, respectively. Results GERD symptoms were significantly relieved after the treatment, with 63 patients (70. 0% ) showing obvious improvement in 2 months, 15( 16. 7% ) being improved in 2 to 6 months, 8(8. 9% ) being relieved after 6 months, and 4(4. 4% ) showing no changes. The mean GERD-HRQL scores was 25.6 at baseline,and decreased to 7. 3 ( P ＜ 0. 01 ) at 6 months) and 8. 1 ( P ＜ 0. 01 ) at 12 months. The mean heartburn scores was 3.3 at baseline and decreased to 1.2 at 12 months ( P ＜ 0. 05 ). Before Stretta procedure, only 31.1% of the patients were satisfied with symptom control by medication, which was increased to 86. 7% after treatment. The score of overall satisfaction with treatment imoroved from 1.4 at baseline to 4. 0 at 12 months after the procedure (P ＜0. 01 ). All patients needed proton pump inhibitors (PPIs) to control symptoms before the treatment, including 67.8% of patients who needed PP1 combined with 2 other medicines or above, while at 6 months after the procedure, 76. 7% of patients were independent of PPI, or only accepted antacids or H2-receptor antagonists on demand. Out of 41 patients with erosive esophagitis before the procedure, 33(80. 5% ) showed normal esophagus at 6 months after the procedure, with 8 patients (19. 5% )having reflux esophagitis of Grade A. Conclusion Stretta procedure can achieve significant improvements in symptom control and degree of esophagitis, it also can decrease the use of medicine. It is well tolerated,safe, effective and endurable for GERD patients.

Biodegradable four-arm star-shaped poly(ethylene glycol)-block-poly(L-lactic acid) copolymer (sPEG-b-PLLA), four-arm star-shaped poly(L-lactic acid) (sPLLA), linearly poly(ethylene glycol)-block-poly(L-lactic acid) copolymer (PEG-b-PLLA) and linearly poly(L-lactic acid) (PLLA) were synthesized from L-lactice acid, pentaerythritol, poly(ethylene glycol) and star-shaped poly(ethylene glycol), using the method of melt polycondensation, and the products were characterized and confirmed by 1H NMR spectroscopy, FT-IR and GPC. Four types of ibuprofen loaded microspheres based on the above four types of polymers, i.e., IBU/PLLA, IBU/sPLLA, IBU/PEG-b-PLLA, and IBU/sPEG-b-PLLA microspheres were prepared using the method of solvent evaporation, and the optimized preparation technology was obtained via orthogonal experiments, and the drug-encapsulating properties and in vitro drug-releasing properties were studied. The results showed that compared with IBU/PLLA and IBU/PEG-b-PLLA microspheres, the drug encapsulate efficiency of IBU/sPLLA and IBU/sPEG-b-PLLA microspheres were higher and the in vitro drug releasing rate slowed down, which mainly due to the faster degradation of sPLLA and sPEG-b-PLLA for the star-shaped structure and the block copolymerization of sPEG. The drug releasing curves of these three types of microspheres could be fit by first-order equation, and the releasing mechanism was non-Fickian diffusing, i.e., the synergetic effect of polymer degradation and drug diffusion.

was 60.0%,50.0%,3.3% and 0.0% higher than those of group P,the difference between the two groups had statis-tical significance(χ2 =6.405,20.000,all P <0.05));group E after operation from the room time for(30.6 ±5.2) min,longer than those of the group P (21.4 ±3.3)min(t =7.118,P <0.05).Conclusion Effect of etomidate com-bined with dezocine anesthesia while postoperative nausea,dizziness and other complications,but the effects on respi-ration,circulation is small,suitable for middle aged and old women painless curettage.