Recently,much interest has been focused on the clinical application and biology of tumor-derived DNA in the plasma/serum of cancer patients.Such interest has resulted in the demonstration of human papillomavirus(HPV) DNA in the plasma/serum of patients with cervical cancer(CC).The studies used different materials(plasma /serum),different DNA extraction methods and different primers to detect circulating free HPV DNA,so the positive rates varied from(6.9%) to 50%.The HPV DNA in the plasma/serum of patients suffering from CC most likely originates from the tumor itself,which will probably provide us with a new tool for CC monitoring after primary treatment,especially in patients in advanced stages.It is expected that this promising molecular tumor marker would soon be put into routine clinical use.

Objective:To explore the infuence of calf spleen extractive injection combined with chemotherapy on immune function of the patients after colorectal carcinoma. Methods:Totally 128 cases of postoperative colorectal carcinoma patients were randomly di-vided into two groups with 64 ones in each. The control group only received FOLFOX 4 regimen, while the study group received calf spleen extractive injection additionally from the first day to the tenth day, 10ml, ivd, and 14-day was one cycle. After 4 weeks, im-mune function, peripheral blood leukocytes ( WBC) , hemoglobin ( Hb) and platelet ( Plt) in the two groups were compared, and the adverse reactions were evaluated as well. Results: After the treatment, CD3 +, CD4 +, CD8 + and CD4/CD8 were increased in the study groups, and those in the study group were much higher than those in the control group (P<0. 05). After the treatment, there were no significant changes in WBC, Plt and Hb in the two groups (P>0. 05), while WBC and Plt in the study group were higher than those in the control group (P<0. 05). The incidence of adverse reactions in the study group was lower than that in the control group (P<0. 05). Conclusion:Calf spleen extractive injection combined with chemotherapy not only can increase the immune func-tion, but also alleviate myelosuppression and gastrointestinal toxicity in the treatment of postoperative colorectal carcinoma patients.

The main factors which affect the farmers'participation in the new rural cooperative medical service are the problems,which exist in the system of the rural cooperative medical service,the institutions of medical service,the government and the farmers themselves etc.Only by constituting the corresponsive policy measures according to these factors can the farmers actively participate in the new rural cooperative medical service.

Objective:To distinguish lung adenocarcinoma (ADC) from squamous cell carcinoma (SCC) using 18F-fluorodeoxyglucose (FDG) PET-based radiomic features. Methods:A retrospective analysis was performed in 182 patients (109 males, 73 females, age (59.0±8.3) years) with non-small cell lung cancer (NSCLC) who underwent 18F-FDG PET/CT scan between January 2018 and December 2019 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. All patients had been diagnosed pathologically with lung ADC or SCC. The patients were divided into a training set ( n=91) and a validation set ( n=91) using simple random sampling method. Radiomic features were extracted from the PET images of segmented tumors using the Python package. The minimum redundancy maximum relevance feature selection algorithm and least absolute shrinkage and selection operator were employed to select informative and non-redundant features, and a radiomics signature score (rad-score) was developed. Differences of rad-score between groups were compared by Mann-Whitney U test. Multivariate logistic regression was applied to select the important factors. A combined model was constructed based on the clinical variable and radiomics signature. The predictive performance of models was analyzed and compared using receiver operating characteristic (ROC) curves and Delong test. Results:Four radiomic features, namely HHL_first order_maximum, LHL_first order_entropy, HHH_ gray level dependence matrix_large dependence high gray level emphasis (GLDM_LDHGLE), HHL_GLDM_LDHGLE (H/L represent the high/low pass filter) were selected to build the rad-score. The rad-score showed a significant ability to discriminate between different histological subtypes in the two sets(training set: -1.30(-1.70, -1.04) vs -0.60 (-1.11, 0.20), z=-4.61, P<0.001); validation set: -1.31(-1.66, -0.96) vs -0.73(-1.02, -0.24), z=-4.76, P<0.001). The area under the curve (AUC) of the rad-score were equal to 0.815 (95% CI: 0.723-0.906) in the training set, and 0.813 (95% CI: 0.726-0.901) in the validation set, respectively, which were larger than those of the clinical variables (smoking had the best prediction performance, training set: 0.721 (95% CI: 0.617-0.810), validation set: 0.726 (95% CI: 0.623-0.814)), however, the difference was not significant ( z values: 1.319, 1.324, both P>0.05). When the clinical variable (smoking) and radiomics signature were combined, the complex model showed a better performance in the classification of histological subtypes, with the AUC increased to 0.862 (95% CI: 0.785-0.940; sensitivity: 88.00%(22/25), specificity: 72.73%(48/66)) in the training set and 0.854 (95% CI: 0.776-0.933; sensitivity: 75.00%(21/28), specificity: 84.13%(53/63)) in the validation set. The AUC values were significantly higher than those of the clinical variable (smoking; training set: z=3.257, P<0.001; validation set: z=3.872, P<0.001). Conclusion:Individualized diagnosis model incorporating with smoking and radiomics signature can help differentiate lung cancer subtypes in a non-invasive, repeatable modality.

0.05).In LADA patients,multipe linear regression analysis showed that the risk factors related to the intima media thickness of common carotid artery were age,smoking and LDL-C and the risk factors related to the intima medial thickness of femoral artery were age,sex and LDL-C.Conclusion The prevalence of subclinical atherosclerosis between LADA and type 2 diabetes is similar.LDL-C,age,sex and smoking may be the risk factors of subclinical AS in LADA patients.

20 mm),these three imaging techniques(HAP-MDCT,Lipiodol CT and DSA)had the same sensitivity,for 10~20 mm hepatic nodules,the detecting rate was no significant difference among them,while,for

Objective To evaluate the sensitivity and specificity of a nested polymersase chain reaction (nested PCR) for detection of the Mycobacterium tuberculosis IS6110 in paraffin embedded tissues. Methods 31 samples from tuberculosis patients and 5 biopsy specimens from patients with hepatitis were subjected to detection of Mycobacterium tuberculosis IS6110 by nested PCR. PCR products of two randomly selected samples were cloned and sequenced. Results Mycobacterium tuberculosis IS6110 was positive in 28 of 31 samples of tuberculosis. The sensitivity and specificity of nested PCR for detection of IS6110 were 90.3% and 100%, respectively. The predictive value of nested PCR was 100%. The sequences of two samples were compared with known sequence of H37Rv isolate (reported by Thierry D) and with nucleotide homology of 97% and 95.3%, respectively. Conclusions Nested PCR is sensitive and specific in the diagnosis of Mycobacterium tuberculosis infection in tissues of routinely paraffin embedded. We propose the diagnostic application of nested PCR for the identification of Mycobacterium tuberculosis infection, especially in the cases which can not be distinguished with certainty from other diseases by histopathology and Ziehl Neelsen's staining.

Objective　To summarize the experience in diagnosis and treatment of rare type of hepatic benign tumor and tumor-like lesions.Methods　The clinical data of 58 cases of uncommon benign hepatic tumor and tumor-like lesions admitted to Changhai Hospital from January 1980 to June 2000 were retrospectively reviewed. Results　Of the 58 cases, 26 were inflammatory pseudotumors, 8 focal hyperplastic lesions, 7 hepatocellular adenomas, 7 lipomatous tumors, 5 cystadenomas, 3 tuberculosis, 1 harmatoma and 1 neurofibroma. 82.8% of the cases had symptoms, 17.2% without obvious symptoms. Single lesion was found in 93.1%, multiple lesions in 6.9%. Operative procedures as follows: 30 local resections of the lesion, 14 hepatic segmentectomies, 9 hepatic lobectomies, 2 hepatic artery ligations, 1 hepatic artery ligation plus drainage of cyst, 2 liver biopsies. No operative mortality and no serious morbidity were noted. Conclusions　With popularization of advanced imaging techniques, the incidences of the benign tumor and tumor-like lesions of the liver have been increased in recent years. However, current imaging studies lack specificity, and differential dignosis of these lesions remains difficult. So we should be familiar with the clinical behavior, presentation of imagings and management of the diseases mentioned above.

Objective To determine the effect of Nuclear factor-erythroid 2-related factor 2 ( Nrf2 ) on acute hephrotoxicity induced by CCl4 in male rat.Methods 20 male Wistar rats were randomly divided into control group and CCl4 group, 10 rats in each group, another 10 male Wistar rats were transgenic rats microinjection through the carrier, obtained the Nrf2-tk gene integration and specific transgenic rats, as the CCl4 +Nrf2 integration group.The groups was given 1%polysorbate 80 for 4 days,Then the CCl4 and CCl4 +Nrf2 integration group were intraperitoneally injected with a single dose of CCl47.5 mg· kg-1 and were killed 24 h after CCl4 injection.The serum chemical parameters including asparate aminotransferase ( AST) ,alanine aminotransferase ( ALT) and lactate dehydrogenase ( LDH) were measured.Also malonaldehyde ( MDA) ,glutathione ( GSH) ,oxidized glutathione ( GSSG) levels in the liver as well as glutathione ( GSH)/oxidized glutathione ( GSSG ) ratios were detected. Histopathologic changes in the liver were examined. Results F1generation TK transgenic rats in liver and testis and other tissues and organs were not detected the transcription of Nrf2-tk, indicating that Nrf2-tk expression in tissues is specific good.Nrf2 significantly reduced serum AST, ALT and LDH levels in a dose-dependent manner.The results of MDA levels and GSH/GSSG ratios in liver and kidney showed that Nrf2 reduced CCl4-induced hepatic lipid peroxidation,and ameliorated glutathione depletion.The histopathologic results showed that Nrf2 restrained liver and kidney damage induced by CCl4 .Conclusion Nrf2 can effectively protect male rat from acute hepatotoxicity and nephrotoxicity induced by CCl4 .

Medical integration is an inevitable trend of medical development and medical educa-tion reform nowadays. Under the guidance of integration,medical colleges at home and abroad develop a series of exploration and practice of medical education reform. According to difficulties and problems of medical education reform,this article put forward:changing ideas to adapt to the transformation of medi-cal model,combining medical education reform and new medical reform,playing the main role of educa-tion administration department in the reform of medical course system,strengthening multi-dimensional integration of medical science.