Objective To investigate the change ofpermeability surfaces (PS) of CTperfusion(CT-p) before chemotherapy and early period treatment with chemotherapy (the first cycle of chemotherapy) in advanced non-small cell lung cancer and explore the correlation with the efficacy of chemotherapy.Methods Eighty patients with advanced non-small cell lung cancer which confirmed by pathology were taken standardized treatment by first-line drug.All patients performed with the CT-p technique before chemotherapy and one cycle after chemotherapy.The efficacy was evaluated by RECIST after 4 cycles of chemotherapy,the patients were divided into complete remission (CR) + partial response (PR),stable (SD),development (PD) according to the results and the change of PS was compared among these groups before chemotherapy and after 1 cycle of chemotherapy.Results Seventy-four patients' values of PS were useful.The remission rate and the stability rate was 32.4％ (24/74) and 78.4％ (58/74) respectively after 4 cycles of chemotherapy.PS after 1 cycle of chemotherapy in CR +PR (24 cases) and SD (34 cases) was lower than that before chemotherapy (12.38 ± 1.86 vs.18.13 ± 2.45,13.24 ± 1.97 vs.17.93 ± 2.38),and there was significant difference (P ＜0.05).There was no obvious change in PS before chemotherapy and after 1 cycle of chemotherapy in PD (16 cases),and there was no significant difference(P＞ 0.05).Conclusions The value of PS which reflects the change of perfusion in tumor vessel at early chemotherapy and the prognosis of the non-small cell lung cancer.Use the change of PS to predict the prognosis of patients with chemotherapy.It could be the norm of calculating the curative effect of chemotherapy in non-small cell lung cancer.

Hepatocellular carcinoma (HCC) complicated by arterioportal shunt (APS) is commonly seen in clinical practice,with an incidence rate of 28.8％-63.2％.It is manifested as abdominal pain,diarrhea,and ascites and can also lead to serious complications of portal hypertension including gastrointestinal bleeding.Although there are various therapeutic methods,they tend to have poor clinical effects.APS is one of the most important causes of death in patients with HCC.This article introduces the etiology,typing,clinical manifestation,and therapies of HCC complicated by APS and points out that although there are various therapeutic methods for HCC complicated by APS,interventional treatment remains the most important method.The exploration of interventional treatment helps to improve patients' prognosis.

Objective:To compare the effect of intraoral and extraoral approach for the sugical treatment of mandibular cysts in the angle and ramus. Methods:Cysts in the mandibular angle and ramus were treated by intraoral approach in 57 cases and extraoral in 18 cases. The following data were collected: operation time, peroperative blood loss, postoperative infection, mouth opening, recurrence rate, injury of the submandibular branch of the facial nerve and sensory function of the inferior alveolar nerve. The data of the two groups were compared statistically. Results:Average operation time (min) of intraoral and extraoral appoarch was 84.65?5.16 and 122.78?10.84(P0.05). Conclusion:Intraoral approach is effective in the treatment of cyst in mandibular angle and ramus.

Objective To analyze the onset, clinical manifestation, causation, complications of pediatric uveitis. MethodsOne hundred and two patients with uveitis under 16 year-old were retrospectively studied. They visited the clinic in Peking University First Hospital from November 1979 to December 2008. Their age ranged from 2.5 to 16 years old, with a mcan of 11.9 years. Routine exam was carried out, including visual acuity, slit lamp, fundus, and laboratory workup. The diagnosis and classification were made by the anatomic location according to the standard of The International Uveitis Working Group. The data of disease history, age of onset, manifestation, recurrence, causation, systemic diseases, complications, and lab examination were analyzed. Results A total of 102 patients (170 eyes)with pediatric uveitis were included in this study, 68 patients (66.6%) were bilateral cases. Anterior uveitis represented in 38 patients (37.3% ), intermediate uveitis in 19 (18.6%), posterior uveitis in 10 (9.8%),and panuveitis in 35 (34.3%). The disease duration was from five days to 2.4 years, with a mean of 3.6 months. The follow-up time was two weeks to more than ten years. The first three causes of pediatric uveitis were juvenile idiopathic arthritis, Vogt-Koyanagi Harada disease, and Behcet's disease. 36 patients were found with complications, and among them 19 had complicated cataract, seven had secondary glaucoma, five had corneal band dystrophy, 12 had iris synechia (both anterior and posterior), one had retinal detachment, two had eye atrophy, and one patient with juvenile idiopathic arthritis had bilateral femoral head necrosis because of the use of steroid and hip joint was replaced. There were ten children suffering more than two complications. Conclusions Pediatric uveitis is a possible blindness disease with variety of etiology and manifestations, and tends to cause complications. Early and special attention must be taken to avoid serious consequences.

Different from the general local hospital,the affiliated hospital of medical school plays double social roles that it not only serves as a teaching hospital but also a medical uniL Every medical staff in it shoulders the responsibility of teaching,researching and medical treatmenL According to the relative independence of affiliated hospital in comprehensive university,the particularity of professional and technical post,the multiplicity of post task,as well as problems existed in the current appraisal and appointment of professional and technical posts such as lacking objectivity and maneuverability in clinical skills examination and evaluation.the paper tries to put forward a new mode of clinical skills examination and evaluation system in accordance with the characteristics of affiliated hospital.

Objective To investigate the activation mechanism of matrix metalloproteinase-13 zymogen (pro-MMP-13) induced by nitric oxide (NO). Methods Human chondrosarcoma cells (SW1353) were grouped and treated with the NO donor S-nitroso-N-acetyl-penicillamine (SNAP), SNAP + NO scavenger oxyhemoglobin (OxyHb), and SNAP + tissue inhibitor of metalloproteinase material -2 (TIMP-2) respectively. After stimulation, matrix metalloproteinase -13 ( a-MMP-13 ) expression level was detected. Besides, the expression levels of MT1- MMP were detected after SW1353 cells stimulated with SNAP and SNAP + OxyHb, respectively. At last, the activities of the recombinant MMP-13 (r-MMP-13) were detected after r-MMP-13 stimulated with SNAP, recombinant MT1-MMP (r-MT1-MMP) and r-MT1-MMP + TIMP-2,respectively. Results SNAP increased human chondrocytes a-MMP-13 expression, OxyHb and TIMP-2 inhibited a- MMP- 13 expression. SNAP also increased the expression of MT1- MMP levels, OxyHb inhibited the expression of MT1-MMP. r-MT1-MMP activated the r-MMP-13, but SNAP did not, TIMP-2 inhibited the activity of r-MMP-13 induced by r-MT1-MMP. Conclusions NO can not directly activate pro-MMP13 by the role of S-nitroso-(S nitrosylation). MT1-MMP mediates the activiation of pro-MMP-13 induced by NO.

Objective To study the association among the color Doppler flow pattern, vascular distribution and the lymph nodes metastasis in breast carcinomas. Methods Sixty-eight patients with infiltrating mammary gland duct carcinoma were divided into the no-lymph-nodes-metastasis group (group I , 37 cases) and the lymph-nodes-metastasis group (group Ⅱ , 31 cases), group Ⅱ were subdivided into group Ⅱa (19 cases): lateral lymph nodes positive of pectoralis minor and group Ⅱ b (12 cases): rear of pectoralis minor and subclavian lymph node positive. Blood flow parameters [peak systoltc velocity (PSV),resistent index ( RI)] and vascular Alder grades were observed and measured with color Doppler ultrasound.The results were compared with the incidence of lymph node metastasis. Results PSV and RI were not significantly different between group Ⅰ and group Ⅱ (t = -0.19,-0.63,P＞ 0.05),and also between group Ⅱ a and group Ⅱ b (t =-1.12,-013,P ＞0.05). By using vascular Alder grades,there were no significant differences between group Ⅰ and group Ⅱ (x2= 0.46, P＞ 0.05 ), but the significant differences were observed between group Ⅱ a [10.5%(2/19) ,63.2%( 12/19) ,26.3%(5/19) in Alder Ⅰ , Ⅱ , Ⅲ grade] and group Ⅱ b [8.3%( 1/12), 16.7%(2/12),75.0%(9/12)in Alder Ⅰ , Ⅱ ,Ⅲ grade](x2 = 7.41,P＜0.05). Conclusion The pattern of blood flow has no correlation with lymph nodes metastasis, vascular Alder grades of carcinoma shows some relevance with the lymph nodes metastasis in the patients with infiltrating mammary gland duct carcinoma.

To improve the teaching effect of head and neck imaging and to further train most high quality talents majoring in head and neck imaging,some teaching experiences were summarized in this article. First,the‘step teaching method’was put forward for students to master the head and neck imag-ing anatomy. Second,students were taught to familiarize the imaging modalities of head and neck and to know the optimal imaging pathway and protocol of this region. Last, students were taught to develop good ideas for analyzing imaging of head and neck disease including localization diagnosis and characteri-zation diagnosis. Additionally,teaching supervision system,including taking notes,attending morning shifts,following up patients and reading literatures,was established for students.

Objective To investigate the influence of insulin pump on type 2 diabetes mellitus.Methods 51 patients were randomized into two groups: 31 cases controlled with insulin pump,20 treated with oral antidiabetic drugs.Serum level of C-peptide concentration was observed.Results There was a markedly increase in C-peptide level in both insulin treating group(P<0.001) and oral drug group(P<0.01).Half an year later,the insulin group was improved in β-cell function better than oral drug group.Conclusions Several days controlling of severe hyperglycemia with insulin pump could not eliminate the β-cell inhibition of glucose toxicity.Newly diagnosed severe type 2 diabetes(FPG≥14 mmol/L) could be treated with insulin for several months.

Objective To observe the clinical efficacy of application at Shenque (CV8) in treating primary dysmenorrhea due to blood stagnation.Method Sixty patients with primary dysmenorrhea due to blood stagnation were enrolled and randomized into a treatment group and a control group to receive the corresponding intervention, started 3 d prior to menstruation. The treatment group was intervened by application at Shenque with Chinese herbal medicinewhile the control group was by orally taking Ibuprofen sustained release capsules, successively for 3 menstrual cycles. The pre-treatment, short-term and follow-up dysmenorrhea scores and traditional Chinese medicine symptom and sign scores for blood stagnation were recorded, and the clinical efficacies of the two groups were observed.Result The short-term total effective rate was 93.3% in the treatment group, slightly lower than 96.7% in the control group, while the long-term therapeutic efficacy in the treatment group (93.3%) was obviously higher than that in the control group (50.0%). The changes in the symptom and sign scores for blood stagnation in the treatment group were more significantthan those in the control group, especially in the scores of menstruation amount, blocked menstrual flow, color of menstrual blood and blood clots (P<0.01). No adverse events occurred during the whole study. Conclusion Application at Shenque can effectively release menstrual pain and improve the symptoms of dysmenorrhea due to blood stagnation.