Objective To analyze the correlation between 18F-FDG SUV and immunohistochemical index including GLUT1, Ki-67, MVD, survivin and cyclinA in non-snall-cell lung cancer. Methods Thirty-three patients with NSCLC underwent preoperative PET/CT examination and surgical operation. All patients were divided into two groups according to the size of tumor (cutoff=3 cm), metastasis of mediastinal or hilar lymph nodes or not, and histological types of the cancer, respectively. The expression of GLUT1, Ki-67, MVD, survivin and cyclinA were estimated with SP immunohistochemical technique, and were analyzed statistically to reveal the correlation to FDG SUV. Results The rate of positive expression of GLUT1, Ki-67 and CD34 were 66.67%, 72.73% and 100%, respectively. The mean value of CD34 in all 33 patients was 12.6±2.9 (12-56). The rate of positive expression of survivin was 84.85%, and the corresponding data of cyclinA was 27.27%. Conclusion There is linear correlation between FDG PET SUV and GLUT1, but not between FDG PET SUV and Ki-67, MVD, survivin and cyclinA. The expressions of GLUT1, Ki-67, MVD, survivin and cyclinA are not related with the size of tumor, nor metastasis of lymph nodes. The expression of GLUT1 and Ki-67 is related with histological types of the cancer, but not with MVD, survivin and cyclinA.

Objective:To compare and study coronary artery lesions characteristics of patients with non -ST -seg‐ment elevation acute myocardial infarction (NSTEMI) .Methods :A total of 66 patients diagnosed as acute NSTEMI were enrolled as NSTEMI group ,meanwhile 74 patients with unstable angina pectoris (UAP) were regarded as UAP group and 76 patients with acute ST -segment elevation myocardial infarction (STEMI ) were regarded as STEMI group .All patients received coronary angiography (CAG) and optical coherence tomography (OCT) examination . Coronary artery lesions characteristics were compared among three groups .Results:Pairwise comparison showed , that occlusion lesion (33.3% ) and serious stenosis (70% ~94% ) lesion (34.8% ) in NSTEMI group were signifi‐cantly more than those of UAP group (14.9% ,8.1% ) respectively;the occlusion lesion and serious stenosis lesion of STEMI group were no significant difference compared with those of STEMI group , P>0.05 all;type C lesion 43.9% of NSTEMI group was significantly more than that of UAP group (27.0% ) and of STEMI group (31.6% ) respectively ( P<0.05 all);vulnerable plaque of NSTEMI group (56.1% ) was significantly more than that of UAP group (23.0% ,P<0.01) ,but was no significant difference compared with STEMI group (56.6% ,P> 0.05). Conclusion :Serious stenosis lesion ,type C lesion and vulnerable plaque of NSTEMI group are significantly more than those of UAP group ;in NSTEMI group , type C lesion is significantly more than ,and occlusion lesion occlusion le‐sion significantly less than that of STEMI group .

Objective To evaluate the impact of PET/CT on the clinical therapeutical strategy of patients with non-small cell lung cancer (NSCLC). Methods Sixty patients with histologically confirmed NSCLC supposed to accept radical radiotherapy or surgical operation were firsthy divided into group A (stage Ⅰ-Ⅱ) and group B (stage Ⅲ) according to CT findings, and the individualized treatment strategy was designed, then restage and compare with different stage and management with initial treatment strategy by PET/CT scanning. Results ①PET/CT scanning restaged the TNM stage in 53.33% (32/60) patients, including 3 of T stage, 23 of N stage and 9 of M stage. Changes of stage occurred in 65.85% (27/41) patients with adenocarcinoma and in 26.32% (5/19) with squamous carcinoma (P＜0.05), while in 34.29 (12/35) with central and 57.14% (20/35) with peripheral NSCLCs (P＜0.05). ②PET/CT scanning resulted in alteration of the managements of NSCLC patients. The management changed from radical into palliative strategy with PET/CT information in 9 (15.00%) patients. In 25 patients who were supposed to accept surgical operation, the treatment changed to radical radiotherapy in 8 (8/25, 32.00%) and to palliative radiotherapy in 5 (20.00%) patients. In 35 patients who were supposed to accept radiotherapy, surgical operation or palliative radiotherapy was finally chosen in 5.71% (2/35) and 11.43% (4/35) patients, respectively. Conclusion PET/CT images can make significant alteration to clinical stage and treatment plan in patients with NSCLC.

The national examination of doctors' qualification is the examination which assesses the medical students' knowledge and skills for doctors' work. This paper introduced autorities concerned, implementing agencies, examination forms and procedures, examination contents and keypoints, pass-ing criteria and matters needing attention of national examination of doctors's qualification be tween Canada and Australia expecting to provide references for the revolution of Chinese Examination of Doctors' Qualification.

Objective To investigate the role of CTLA4-Ig and anti-CD40L monoclonal antibody in the acute rejection of pancreaticoduodenal transplantation model of rats.Methods Pancreaticoduo- denal transplantation model was established from the donor F344 rats to the Lewis recipients(diabetes models).The models were divided into 4 groups:groups A,B,C and D with 12 rats in each group. Two days after transplantation,recipients were injected intraperitoneally with saline,CTLA4-Ig(200?g),anti-CD40L monoclonal antibody(200?g),CTLA4-Ig(200?g)combined with anti-CD40L monoclonal antibody(200?g)respectively.On the day 1,4,7,10 after transplantation,the grafts were harvested for histopathological examination and RT-PCR to determine the levels of interleukin (IL)-2,interferon(IFN)-?,IL-4 and IL-10;The blood CD3~+,CD4~+and CD8~+ T cells were detected by flow cytometry.On the day 4 after transplantation,the CD4~+ CD25~+ T cells in the grafts were de- tected by flow cytometry.Results As compared with group A,the severity of the rejection of grafts in groups B,C and D were depressed;Down-regulation of IL-2 was observed in the groups B,C and D, and the levels in group D were lowest.Down-regulation of IFN-7 was detected in the groups B,C and D,but there was no significantly difference between groups D and B or groups D and C.Up-regulation of IL-4 was observed in the groups B and C,and the levels in group D were lower than in groups A,B and C.Up-regulation of IL-10 was observed in groups B and C,and there was significant difference between groups D and B or groups D and C.The CD3~+,CD4~+ and CD8~+ T cells in groups B,C and D were less,but more CID4~+ CD25~+ T ceils in transplanted pancreas were observed,more notably in group D than in group C.Conclusions Combined use of CTLA4-Ig and anti-CD40L monoclonal anti- body can remarkably diminish the severity of the rejection,which might be mediated by altering the balance in Th1/Th2 and increasing the number of CD4~+ CD25~+ regulatory T cells.Co-stimulation blockade with CTLA4-Ig and anti-CD40L monoclonal antibody induction seems to be an attractive strategy to control allograft rejection.

Adolescent ; Cardiac Catheterization ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; pathology ; surgery ; Humans ; Infant ; Male ; Postoperative Complications ; pathology

Objective To examine the incidence and risk factors associated with atrial fibrillation in elderly coronary heart disease patients who underwent off-pump coronary artery bypass surgery.Methods From Jun.2008 to Jun.2009,one hundred and eleven patients received OPCAB in our hospital.Clinical data including coronary angiography,diseased vessels,number of bypass grafts,postoperative electrolyte,postoperative hemodynamic measurements,anti-arrhythmic drugs used and other risk factors for atrial fibrillation was collected and reviewed individually.The mean age of patients was(73.19±2.79)years(range from 70 to 82 years).Seventy-nine patients were male and 32 were female.The mean left ventricular ejection fraction(LVEF)was 0.57±0.12,NYHA Ⅰ-Ⅳ.All patients received OPCAB.Saphenous vein(SV)and left internal mammary artery(LIMA)were harvested and used as grafts.LIMA was routinely anastomosed to the left anterior descending artery (LAD),and SV was anastomosed to the other target vessels.The average number of grafts.was(2.79±0.54)per case.The mean operation time was(3.70±0.88)hours and the duration of ICU-staying was(1.32±0.94)days.The patients were divided into 2 groups:atrial fibrillation group and non-atrial fibrillation group.Results Four deaths occurred perioperatively.The mortality was 3.42%.Major postoperative complications included low cardiac output,respiratory dysfunction and acute kidney injury.Twenty seven out of 111 patients who underwent off-pump coronary artery bypass surgery had atrial fibrillation postoperatively.The incidence was 24.3%.Single factor analysis revealed that CVP,serum levels of potassium,magnesium,and SPO2 were lower significantly in atrial fibrillation group than those in the non-atrial fibrillation group,P<0.05.Conclusion Changes of perioperative electrolytes and circulating blood volume,decline in the oxygen saturation,and the occurrence of perioperative myocardial infarction after coronary artery bypass surgery were the risk factors associated with atrial fibrillation.

Arteriovenous Fistula ; complications ; diagnosis ; diagnostic imaging ; Child ; Contrast Media ; Coronary Angiography ; Coronary Vessels ; pathology ; Female ; Humans ; Superior Vena Cava Syndrome ; diagnosis ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed ; Vena Cava, Superior ; abnormalities ; diagnostic imaging

Child ; Female ; Heart Block ; etiology ; Heart Septal Defects, Ventricular ; complications ; therapy ; Humans

Objective:To explore the correlation between the characteristics of contrast-enhanced sonography of intraoperative glioblastoma multiform (GBM) and molecular markers of isocitrate dehydrogenase-1(IDH1).Methods:A retrospective analysis were performed in 30 patients who underwent neurosurgery and pathologically confirmed to be GBM at Beijing Tiantan Hospital from May 2018 to April 2019. All neurosurgical glioblastoma patients after craniotomy underwent conventional ultrasound and contrast-enhanced ultrasound(CEUS) guided navigation. The characteristics of the ultrasound imaging (whether the tumor involves the structure of the corpus callosum, the clarity of the tumor boundary after enhanced ultrasound and whether the tumor has necrotic areas with enhanced ultrasound images) were analyzed. The ratio between tumor necrosis area and whole tumor area (N/W) was measured, and the correlation with IDH1 gene expression was analyzed.Results:There were statistical differences in clarity of tumor boundary after CEUS and tumor necrosis after CEUS between positive IDH1 and negative IDH1 groups(all P<0.05). The positive expression of IDH1 was negatively correlated with the N/W area of the contrast-enhanced ultrasound mode( r=-0.756, P<0.05), suggesting that the expression level of IDH1 gene was negatively correlated with the area of tumor necrosis. Conclusions:Ultrasound contrast agent examination can more accurately distinguish the active proliferation area, hemorrhagic necrosis area and peripheral edema area of glioblastoma. Accurately identifying the extent of tumor necrosis area through ultrasound contrast agent examination can predict expression of IDH1.