Positron emission tomography (PET)/CT plays an important role in the diagnosis of bone metastasis from lung cancer,and can reflect the pathophysiological and morphological changes in lesion of bone metastasis.The sensitivity,specificity and the overall accuracy of PET-CT for the diagnosis of bone metastasis in patients with lung cancer are higher than those of routine methods such as X-ray,CT scan,MRI and SPECT/CT.

The recent advances in of molecular biology and pathogenesis of chronic myeloid leukemia(CML) were summarized. This article focused on the significance of p210~(BCR/ABL) on CML and the possible signal transduction pathway molecular mechanisms of CML, characteristic hematology of CML bone marrow and its relationship with clinical manifestations. Some points of the recent discovery might provide useful pointers for monitoring and treating CML.

Objective:To investigate the status of glucolipid metabolism and insulin resistance in patients with first-episode non-medicated schizophrenia, and to explore their relationship with psychiatric symptoms and cognitive function.Methods:One hundred and seventeen patients with first-episode non-medicated schizophrenia admitted to Wenzhou Seventh People′s Hospital from January 2018 to August 2020 were included in case group, and 61 healthy subjects with physical examination during the same period were used as control group. The glucose metabolism, including serum fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), fasting insulin (FINS), fasting C peptide; lipid metabolism, including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C); apolipoprotein A1 (Apo-A1) and homeostatic model assessment insulin resistance index (HOMA-IR) level were compared between 2 groups. The abnormal glucolipid metabolism and incidence rate of insulin resistance were counted in the two groups. According to the condition of abnormal glucolipid metabolism or insulin resistance in case group, the patients were divided into abnormal glucolipid metabolism group and non-abnormal group, and insulin resistance group and non-insulin resistance group. The psychiatric symptoms (positive and negative symptom scale, PANSS) and cognitive function (MATRICS consensus cognitive battery, MCCB) were compared between 2 groups. Pearson correlation analysis was used to explore the correlation between glucolipid metabolism and insulin resistance and psychiatric symptoms and cognitive function in case group.Results:The levels of glucolipid metabolism indexes of 2 h PBG, FINS, fasting C peptide, TG and HOMA-IR in case group were significantly higher than those in control group: (7.06 ± 1.88) mmol/L vs. (6.19 ± 1.53) mmol/L, (8.61 ± 2.46) mU/L vs. (6.25 ± 1.71) mU/L, (0.49 ± 0.16) nmol/L vs. (0.32 ± 0.09) nmol/L, (1.33 ± 0.47) mmol/L vs. (1.02 ± 0.24) mmol/L, 2.01 ± 0.71 vs. 1.51 ± 0.45 ( P<0.05); while the levels of HDL-C and Apo-A1 were significantly lower than those in control group: (1.19 ± 0.38) mmol/L vs. (1.57 ± 0.32) mmol/L, (1.21 ± 0.25) g/L vs. (1.43 ± 0.17) g/L ( P<0.05). The total incidence rate of abnormal glucolipid metabolism or insulin resistance in case group was significantly higher than that in control group: 62.39%(73/117) vs. 13.11%(8/61) ( P<0.05). The scores of dimensions of positive symptoms, negative symptoms and general psychopathology and total score of PANSS in combined group were significantly higher than those in non-abnormal group: (25.14 ± 5.09) scores vs. (22.95 ± 4.72) scores, (24.68 ± 5.25) scores vs. (22.05 ± 4.59) scores, (41.52 ± 5.85) scores vs. (38.12 ± 4.18) scores, (94.68 ± 11.64) scores vs. (85.43 ± 8.51) scores ( P<0.05). The above scores points in insulin resistance group were higher than points in non-insulin resistance group: (26.62 ± 4.18) scores vs. (23.62 ± 4.98) scores, (25.92 ± 5.07) scores vs. (23.02 ± 4.96) scores, (42.94 ± 5.26) scores vs. (39.43 ± 4.47) scores, (97.35 ± 10.07) scores vs. (89.37 ± 10.25) scores ( P<0.05). The scores of continuous performance test-identical pairs (CPT-IP), working memory (WM), brief visuospatial memory test-revised (BVMT-R) and Mayer-Salovey-Caruso emotional intelligence test (MSCEIT) of MCCB scale in abnormal glucolipid metabolism group were significantly lower than those in non-abnormal group: (23.82 ± 5.21) scores vs. (27.15 ± 4.69) scores, (21.72 ± 5.95) scores vs. (25.35 ± 5.14) scores, (19.56 ± 5.28) scores vs. (22.34 ± 5.43) scores, (22.62 ± 5.13) scores vs. (26.47 ± 4.96) scores ( P<0.05), and the scores in insulin resistance group were significantly lower: (22.26 ± 4.84) scores vs. (25.42 ± 5.12) scores, (20.35 ± 4.87) scores vs. (23.46 ± 5.08) scores, (18.05 ± 4.27) scores vs. (20.98 ± 5.71) scores, (21.15 ± 4.67) scores vs. (24.48 ± 5.02) scores ( P<0.05). Pearson correlation analysis showed that 2 h PBG in case group was positively correlated with PANSS positive symptoms ( P<0.05), and was negatively correlated with CPT-IP and MSCEIT in MCCB scale ( P<0.05). FINS and HOMA-IR were positively correlated with positive symptoms, negative symptoms and PANSS total score ( P<0.05), and were negatively correlated with CPT-IP, WM, BVMT-R and MSCEIT ( P<0.05). HDL-C was negatively correlated with positive symptoms ( P<0.05), and was positively correlated with CPT-IP, WM and MSCEIT ( P<0.05). Apo-A1 was negatively correlated with positive symptoms and negative symptoms ( P<0.05), and was positively correlated with CPT-IP and WM ( P<0.05). Conclusions:Abnormal glucolipid metabolism and insulin resistance have a higher detection rate in first-episode non-medicated schizophrenia, and have a certain relationship with the psychiatric symptoms and cognitive impairment of patients.

Objective To provide references for epidemiology teaching reform by investigating scores of epidemiological exam and applications of epidemiologic course content in practice.Methods The epidemiological exam scores of students majoring in preventive medicine from 2004 to 2007 grade were statistically analyzed and questionnaire survey was carried out among students of 2006 and 2007 grade.Results The skewness of epidemiological scores from four garades were negative skew,and the kurtosis of 2007 grade was positive,the others were negative;there were statistical differences among the average scores of different grades(F=2.70,P＜0.05);there were statistical differences between 2004 grade and other grades in passing rate(x2=7.94,P＜0.008).Most of the contents applied in survey were prevention and control of infectious deseases(16.0％),prevention and control of chronic diseases(13.9％),surveillance of diseases(11.8％).Conclusions Epidemiology teaching reform should be enhanced and should integrate theory with practice.

Objective To investigate the effects of iodine on the pathogenesis of Graves′ disease (GD). Methods The thyroid epithelium cells (TEC) from GD patients and para adenoma normal tissue from thyroid adenoma patients wereculturedrespectivelywithdifferentNaⅠconcentrations from 0 to 1 mg/L. The HLA DR expression of TEC was detected with Western blot. Meanwhile, the morphological change of TEC was observed after treatment of NaⅠ by scanning electronmicroscope (SEM). Results (1) When the concentration of NaⅠ in culture medium was over 100 ?g/L, the amount of HLA DR expression of TEC increased in GD group (P

Objective To construct the clinical core competence evaluation system of junior nurses by the Delphi method combined with Analytic Hierarchy Process method. Methods We consulted 20 nurse specialists by two-round Delphi method to find clinical core competence evaluation index of junior nurses. To determine the weight of each index by Analytic Hierarchy Process method. Results The expert′s judgment coefficient was 0.92, familiar coefficient was 0.96 and authority coefficient was 0.94. The coordination coefficients of one grade, two grade, three grade and all indexes were 0.42, 0.52, 0.54 and 0.51 respectively. There was statistical significance (P < 0.01). The variation coefficients of each indexes were less than 0.2 and the mean of important values were more than 3.5. The clinical core competence evaluation index system of junior nurses was established including 7 one grade indexes, 28 two grade indexes and 55 three grade indexes. Conclusions The clinical core competence evaluation system of junior nurses was scientific and reasonably. It can evaluate the clinical core competence of junior nurses effectively and can supply objective and quantitative standard for the assessment and appointment of junior nurses.

Objective:To establish a method to determine the content of morphine and codeine phosphate in compound liquorice tablets. Methods:The analysis was performed by HPLC-ESI-MSMS. The acquisition was MRM ( multi-reaction monitor) , the column wasAgilentZorbaxEclipseSBC18(2.1mm×100mm,3.5 μm),themobilephasewasacetonitrileand15mmol·L-1ammoniumac-etate with gradient elution. Results:The precursor (m/z) of morphine and codeine was 286. 0 and 300. 0, respectively, and the quan-titative ion was 165. 0 and 165. 0, respectively. The linearity of morphine was excellent between 25 and 500ng·ml-1 , and the average recovery was 103. 1%. The linearity of codeine was good between 0. 75 ng and 150 ng·ml-1 , and the average recovery was 101. 5%with RSD of 1. 7(n=6). Conclusion:The method is simple and accurate, which can be used for the quality control of compound ligu-orice tablets.

Objective To identify stent fracture by revision of coronary artery angiography and intravascular ultrasound(IVUS) images.Methods Stent fracture has been implicated as a cause of drug-eluting stent failure.IVUS is more likely to identify stent failure(including stent fracture) when compared with angiography.We analysed retrospectively 2 021 cases of angiography and 183 cases of IVUS.Results Six fractures were found in 3 patients by angiography and five of these fractures were confirmed by IVUS in 2 patients.All stent fractures occurred in sirolimus-eluting stents in less than one year after implantation.Angiography analysis showed that 4 stent fractures were complete transverse linear fracture with stent displacement.IVUS analysis showed that 3 stent fractures were complete and 2 were partial fracture.One fracture site was found at the overlapping point of stents and one was found with coronary aneurysm.Conclusion Angiography and IVUS are helpful to identify stent fracture.IVUS can help to understand the possible mechanisms of stent fracture.

OBJECTIVE:To systematically review the efficacy of L-carnitine in the treatment of heart failure,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,Medline,CJFD and Wanfang Database, randomized controlled trials(RCT)about the efficacy of L-carnitine in the treatment of heart failure were collected. Me-ta-analysis was performed by using Rev Man 5.1 software after data extraction and quality evaluation. RESULTS:Totally 42 RCTs were enrolled,involving 3 494 patients. Results of Meta-analysis showed,L-carnitine can significantly improve the effective rate [OR=4.07,95%CI(3.16,5.25),P<0.001],increase left ventricular ejection fraction(LVEF)[MD=4.49,95%CI(3.49,5.49),P<0.001],decrease brain natriuretic peptide(BNP)levels [MD=-130.17,95%CI(-193.81,-66.52),P<0.001] and improve walk-ing distance in 6 minutes [MD=46.12,95%CI(35.72,56.51),P<0.001],the differences were statistically significant. CONCLU-SIONS:L-carnitine has good efficacy in the treatment of heart failure,it can significantly improve LVEF,decrease BNP level and increase walking distance in 6 minutes.

Objective To evaluate curative effect and safety of moxifloxacin in treatment of acute pelvic inflammatory with Meta analysis.Methods The database of Pubmed, MEDLINE, Cochrane, China Biology Medicine disc (DBMdisc), China National Knowledge Infrastructure (CNKI), Wanfang med online and VIP were retrieved, and randomized clinical trials of moxifloxacin in treatment of acute pelvic inflammatory which were open literatures published at home and abroad were collected from January 2000 to December 2014.The literatures which were accorded with the criterion were chosen and analyzed by Review Manager 5.1.7.Results The results showed that there were 14 literatures which were homogenous corresponded with the criterion, changeless benefit model statistics and analysis showed that the odds ratio (OR) was 3.76(95%CI 2.14-6.59, P<0.01).And there were 5 studies on bacterial removal showed that the OR was 2.34(95%CI 1.46-3.75, P<0.01).There were 12 studies on incidence of adverse reactions showed that the OR was 0.5(95%CI 0.30-0.86,P=0.01).Conclusion Meta analysis displayed that moxifloxacin is effective for acute pelvic inflammatory.But the high quality RCTs were too few in domestic studies in treatment of the acute pelvic inflammation with moxifloxacin and the overall level of studied quality needs improvement urgently.