Endoscopic ultrasonography has been widely used in the diagnosis of digestive system disease,and has great important diagnostic significance in the differential diagnosis of the upper gastrointestinal mucosa or submucosal lesions,as well as to distinguish the gastrointestinal intracavitary and extracavitary lesions.At the same time,EUS can more accurately judge the depth of tumor invasion and the surrounding lymph node metastasis,which has great value in the preoperative TNM staging of esophageal cancer and gastriccancer,the judgment of resectability and the prognosis.We summarized the result of EUS in the upper gastrointestinal disease in our hospital.

Objective The aim of the study was to explore the difference between the expression of CDg7 in peripheral blood and bone marrow on acute myeloid leukemia (AML n=30). Methods A flow cytometric quantitative analysis of expression levels for CD87 was performed on fresh blast cells in peripheral blood and bone marrow from patients with acute myeloid leukaemia using CD87, monoclonal antibodies. Analysis the difference between the expression of CD87 using matched t -test. Results The values of CD87 expression in bone marrow of 14 M5 cases are from 9.47 %～80.32 %, and from 11.49 %～87.46 % in peripheral blood. The values of CD87, expression in bone marrow of 8 M4 cases are from 14.27 %～46.28 %,and from 14.79 %～47.19 % in peripheral blood. The values of CD87 expression in bone marrow of 6 M2 cases are from 4.67 %～34.26 %, and from 8.96 %～39.78 % in peripheral blood. The values of CDs, expression in bone marrow of 2 MI cases are from 3.56 %～7.69 %, and from 5.21 %～8.96 % in peripheral blood.The expression of CD87 in peripheral blood and bone marrow from patients with acute myeloid leukaemia had statistical difference (t =3.13, P<0.05). Conclusion The levels of CD87 expression had difference between peripheral blood and bone marrow. The level in peripheral blood was higher than bone marrow. So when we performed quantitative analysis of expression levels for CD87, peripheral blood instead of bone marrow was commended.

Objective To explore the serum levels of progestrone (Prog) and dehydroepiandrosterone sulfate(DHEAS),and the effect of sodium valproate(VPA) and lamotrigine(LTG) on the levels of Prog and DHEAS in infantile spasms.Methods A total of 36 cases of infantile spasms (spasms group) before treatment and 40 cases health infants(control group) were detected the serum Prog and DHEAS levels by electrochemiluminescence immunoassay,and were compared with 21 cases receiving monotherapy with VPA(VPA group),and 13 cases receiving therapy plus lamotrigine(LTG group) before and 4 months after treatment to observe the changes of sex hormone.Results There were no significant differences in Prog and log(DHEAS) (logarithmic transformation) levels between spasms group and control group (P ＞0.05).The serum Prog level of baby girls and baby boys were lower after treatment than those before treatment in VPA group respectively (t =2.603,3.146 ; P =0.003,0.008,respectively).The log (DHEAS) level of baby girls and baby boys were higher in LTG group after treatment than those before treatment respectively(t =3.185,2.663 ;P =0.007,0.041).Conclusion Infantile spasms would not influence the hormone metabolism,while VPA and LTG can influence the sex hormone.The hormone level should be monitored in the treatment.

Objective To study military medical graduates' psychological elastic characteris-tics and the key influencing factors. Methods A comparative study of 817 graduate students and 597 undergraduate students in a military academy was conducted by using positive negative emotions, pos-itive and negative cognitive bias and Mental Resilience Scale. Independent sample t-test, single factor analysis of variance, correlation analysis, and step-wise regression analysis were conducted by SPSS 18.0 for data analysis. Results ①Resilience scores of postgraduate students were significantly lower than those of undergraduate students (76.01 ±11.43 vs. 80.00 ±10.26, t=-6.76, P<0.01). Resilience scores of military postgraduates were significantly higher than those of local postgraduates (77.18 ± 11.59 vs. 74.97±11.19, t=2.77, P<0.05). Resilience scores of female postgraduates were significantly lower than those of males (74.79 ±10.83 vs. 76.94 ±11.78, t=2.68, P<0.05), reflected in factors of tenacity and strength. ②Resilience and its factors were positively related to positive affect and atten-tion to positive information (r=0.448~0.625, P<0.01), while negatively related to negative affect and attention to negative information (r=-0.206~-0.448, P<0.01). ③Regression analysis showed that posi-tive and negative emotion, attention to positive and negative information can significantly predict re-silience, accounting for the variance of 53.7%. ④Positive and negative affect partially mediated the relationship between attention to positive information and positive affect and resilience. Conclusion Attention to positive information and positive affect may be potential targets for intervention to enhance the level of resilience among military medical postgraduate students.

Objective:To investigate the clinicopathological characteristics and 18F-fluorodeoxyglucose (FDG) PET/CT imaging features of bronchopulmonary neuroendocrine tumors(BP-NETs) with different pathological subtypes. Methods:From January 2013 to May 2018, 280 patients (196 males, 84 females, median age 58 years) with BP-NETs proved by pathology in Henan Provincial People′s Hospital were retrospectively analyzed. Age, gender, smoking history, the location and size of tumor, Ki-67 positive index, thyroid transcription factor-1 (TTF-1), synaptophysin (Syn), chromogranin-A (CgA), CD56, maximum standardized uptake value (SUV max), lymph node metastasis and distant metastasis were compared among 4 pathological subtypes of BP-NETs, including typical carcinoid (TC), atypical carcinoid (AC), small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). One-way analysis of variance, χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used for data analysis. Results:There were significant differences in age, smoking history, tumor size and location, Ki-67 positive index, CgA, CD56, TTF-1, SUV max and TNM stage among TC( n=59), AC( n=21), SCLC( n=184) and LCNEC ( n=16) groups ( F values: 2.067, 3.358, H values: 17.749-22.351, all P<0.05). SCLC had the largest tumor size (5.5(3.0, 6.8) cm) and the highest proportion of central type (85.3%, 157/184), and were more prone to lymph node metastasis. LCNEC had the oldest age ((66±16) years), the largest proportion of smoking history (14/16) and peripheral type (12/16). CD56 in SCLC (95.7%, 176/184) and LCNEC(15/16) mostly showed positive expression, while the positive expression rates of CgA and TTF-1 were higher in TC and AC (96.6%(57/59), 93.2%(55/59) and 95.2%(20/21), 90.5%(19/21), respectively). The Ki-67 positive index and SUV max of the four subtypes were significantly different, with the highest in SCLC group and the lowest in TC group. Conclusion:Different pathological subtypes of BP-NETs manifest different clinicopathological features and imaging presentation on 18F-FDG PET/CT, which are useful for understanding their characteristics.

Objective To observe the effect of raloxifene, a selective estrogen receptor modulator, on osteoporosis in the osteoprotegerin (OPG) gene knock-out female and male mice. Methods Two groups of OPG gene deficient (OPG-/-) female and male mice, 20 mice in each group, were assigned to raloxifene-treated (3 mg The effect of raloxifene was evaluated by comparing the values of bone mineral density (BMD) , bone strength,histomorphometric measurement and osteoclast number between the raloxifene treated group and placebo group.Results As compared with placebo group osteoporotic manifestations were improved in OPG-/- female mice treated with raloxifene orally. BMD was increased both in lumbar vertebrae (P<0.05) and femurs (P<0.01).Bone strength was measured in femurs by three-point bending test and vertebrae by stress test. Results showed that ultimate load, ultimate stress and Young's modulus were increased both at lumbar and femur bone, suggesting decreased risk of fracture. Tartrate-resistant acid phosphatase, a marker enzyme of osteoclasts, was detected, and the number of osteoclasts declined significantly after the treatment of raloxifene. At the same time, results of histomorphometric measurements indicated that bone trabecular volume was increased and bone formation rate decreased from(8.05±4.02)mm3·mm-2·year-1 to (5.48±1.89)mm3·mm-2· year-1(P＜0.05).These findings were found in the group of OPG-/- female mice treated with reloxifene but not in male mice. Conclusions Raloxifene is effective in treating osteoporosis in female OPG-/- mice, indicating that its action is at least in part independent of OPG gene. But it is ineffective in male OPG-/- mice.

ObjectiveTo investigate the relationships between insulin-like growth factor-Ⅰ (IGF-Ⅰ) and osteoprotegerin (OPG), RANKL, and bone mineral density (BMD) in healthy women. MethodsBMD of lumbar spine and femoral neck were measured in 504 healthy women by dual energy X-ray absorptiometry and their serum levels of IGF-Ⅰ, OPG, RANKL were also determined. ResultsAge was negatively correlated with serum level of IGF-Ⅰ in healthy women (r=-0.702, P

Objective To investigate the critical value of TSH-stimulated Tg(sTg) in the diagnosis of metastasis from DTC, and to evaluate the diagnostic value of the ratio of sTg to suppressed Tg (sTg/suppressed Tg).Methods A total of 330 post-operative DTC patients(87 males, 243 females, age range: 12-70 years)who underwent thyroid remnant ablation from August 2008 to December 2014 were retrospectively reviewed.Their serum TgAb levels were normal.The patients were divided into non-metastasis group(147 cases)and metastasis group(183 cases) according to results of ultrasonography, CT and WBS.The difference of sTg between the two groups were compared by Mann-Whitney rank sum test.ROC curve was used to analyze the relationship between sTg, sTg/suppressed Tg ratio and metastasis, the cutoff value was calculated.Results The sTg was significantly different between the non-metastasis group and metastasis group: 1.0 (0.1, 2.0) μg/L vs 36.5 (3.9, 126.7) μg/L;u=-6.642, P<0.05.The AUC for ROC curve in metastasis group was 0.85, and the cutoff value was 2.05 μg/L, with the sensitivity 85.2%, specificity 67.3%, and accuracy 82.3%.While sTg<2.05 μg/L, the AUC of sTg/suppressed Tg ratio was 0.941, and the cutoff value was 4.3, with the sensitivity 93.3%, specificity 88.2%, and accuracy 92.3%.Conclusions The sTg has a specific value for the diagnosis of metastasis from DTC after operation and the cutoff value is 2.05 μg/L in this set of patients.The ratio of sTg/suppressed Tg could be used to correct the sTg and to improve the diagnostic sensitivity.

Objective To search the single nucleotide polymorphism (SNP) in exons of osteoprotegerin gene, and to analyse the relationship between SNP and bone mineral densities (BMD) in postmenopausal women. Methods Using PCR and direct sequencing to identify SNP and genotypes in 205 postmenopausal women. BMD at lumbar spine (L 2 4 ) and femoral neck (FN) were measured by dual energy X ray absorptiometry. Serum osteocalcin (BGP), osteoprotegerin (OPG), osteoprotegerin ligand (RANKL) and urinary N telopeptides of type Ⅰ collagen (NTx) were also measured. Results One SNP, G1181C, was found in exon 1 of OPG gene. The frequencies of G1181C genotypes in 205 postmenopausal women were 0.566, 0.346, and 0.088 for the genotypes GG, GC and CC respectively. BMD at lumbar spine (L 2 4 ) of CC genotype was significantly higher than GC and GG genotypes (P

Objective To observe non-displaceable binding potential (BPND) changes of striatal dopamine D2 receptors(SDDR) in patients with first-episode major depressive disorder (MDD) using 11C-Raclopride PET/CT,and to analyze the relationship between BPND and Hamilton rating scale for depression (HAM-D).Methods From December 2014 to December 2015,patients with first-episode MDD and age/gender-matched healthy controls underwent brain MRI and 11C-Raclopride PET/CT in this prospective study.BPND of bilateral SDDR was calculated by molecular imaging and kinetic analysis toolbox (MIAKAT).BPND changes of bilateral SDDR and their relationship with HAM-D score were analyzed.Paired t test,two-sample t test and Pearson correlation analysis were used.Results A total of 20 MDD patients (8 males,12 females,average age: (32.80±9.76) years) and 20 healthy controls (9 males,11 females,average age:(29.25±6.93) years) were enrolled in this study.The 11C-Raclopride uptake in brain tissue of the MDD group and control group were mainly distributed in bilateral striatum,and very few 11C-Raclopride was distributed in bilateral cerebral cortex and cerebellum.In MDD group,the BPND level of bilateral SDDR had no statistical differences(t values: 0.69,0.35,both P>0.05),and similar results were found in the control group(t values: 0.28,0.24,both P>0.05).Compared with the control group,however,the MDD group had lower BPND level of bilateral SDDR(t values: 3.13-4.41,all P<0.05).The BPND of bilateral caudate nucleus and/or putamen D2 receptors was correlated with HAM-D total score,anxiety/somatization factor score,cognitive impairment factor score,retardation factor score and sleep disturbance factor score(r values: from-0.688 to-0.453,all P<0.05).Conclusions The binding potential of SDDR in patients with first-episode MDD is declined,and the BPND level of SDDR is correlated with symptoms of depression.The abnormality of SDDR may be an important molecular mechanism of the abnormality of midbrain-striatal dopamine reward circuits in MDD patients.