Objective To systematically assess the diagnostic performance of CTA for lower extremity peripheral arterial disease (PAD) using a Meta analysis method. Methods Studies were located through electronic searching of the PubMed, EBSCO, Springer, Ovid, CNKI, Cochrane library (from the date of establishment of the databases to October 2009 ). Bibliographies of the retrieved articles were also checked. All the studies concerning the diagnosis of PAD using CTA had been searched and reviewed, and the studies with the DSA as the gold standard were adopted as eligible. Subsequently, the characteristics of the included articles were appraised and extracted. Data on accuracy of included studies were extracted for further heterogeneity exploring, statistical pooling and SROC ( summary receiver operating characteristics)analyzing using the Meta Disc 1.4 software. Results Totally 24 studies met the inclusion criteria with a total of 1096 patients. The heterogeneity was found in these studies. The pooled accuracy indicators like sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.95 ( 95% CI:0.94-0.95 ), 0.96 ( 95% CI:0.95-0.96), and 471.13 (95% CI:242. 92-913.71 ), respectively. The area under of SROC curve was 0.9888 and the Q index was 0.9555. Subgroup analysis demonstrated significant difference on diagnostic performance for various CT slices (P ＜ 0.05 ). Conclusion CTA can be regarded as an effective and feasible method for PAD diagnosis and screening, based on the results of this systematic review. However,more rigorous evaluations of CTA in patients with critical limb ischemia are needed.

Objective To explore the relationship of MDR1 and its encoded product P-gp expressions with clinical efficacy of transcatheter arterial chemoembolization (TACE)in primary liver cancer and their clinical significance.Methods We selected 108 patients with primary liver cancer who came to our hospital between June 2010 and June 2013 as observation subjects.Meanwhile 50 healthy people in our hospital for liver biopsy were selected as controls.MDR1 mRNA level in observation group and control group was determined by real-time quantitative PCR.P-gp protein level was analyzed by immunohistochemistry.According to P-gp level,the 108 patients were divided into drug-resistance groups and non-resistance group;the relationship between P-gp expression level and clinical efficacy was analyzed.Results MDR1 mRNA level in liver tissues significantly enhanced in observation group compared with that in control group (P <0.05).In observation group 32 patients had the ratio of MDR1 mRNA level-normal level of more than 2 and 76 patients had the ratio of MDR1 mRNA level-normal level of less than 2. Immunohistochemistry revealed that MDR1 encoded product P-gp was brownish yellow, mainly expressed in the cell surface of liver cancer cells.There were 35 P-gp protein-negative patients (non-resistance group)and 73 positive patients (resistance group).Clinical efficacy was significantly higher in non-resistance group (74.28%)than in resistance group (43.28%)(P <0.05).The 1 year and 2-year cumulative survival rates were 54. 12% and 27.40% in resistance group and 77.14% and 42.86%% in non-resistance group.They were significantly higher in the latter group (P <0.05 ).Conclusion The overexpressed MDR1 encoded product P-gp in primary liver cancer is associated with multidrug resistance in tumor chemotherapy,suggesting that P-gp can be used as one of the guiding clinical markers of chemotherapy.

Objective To develop a practical testing system on internet,to offer a modern pattern of practicing testing for diagnostic imaging and to evaluate the effects.Methods Practical testing system for diagnostic imaging based on PACS was set up and its effect was evaluated by students.Results The developed practical testing system combines question bank,image reading tool and answering interface together and has functions of controlling and managing both the questions and students participating in the examination.In the satisfaction survey of students,practicing testing system of diagnostic imaging got a score of 96.75 (full mark 100) and was highly prized.Conclusions This pattern of online testing offers more imaging information and makes practicing examination of diagnostic imaging more vivid and scientific.

Purpose:To evaluate the efficacy of using z shape spiral metallic stent in the treatment of tracheal stenosis after lung resectomy and carinal plastic surgery.Materials and meth- ods:Two patients suffered from lung cancer received lung resectomy and carinal plastic surgery, thereafter,tracheamalacia occurred in one patient and intratracheal granulation tissue proliferation in the other,both resulted in tracheal stenosis.Spiral metallic stents were inserted in the narrow seg- ment under bronchoendoscopy.Results:Dyspnea relieved immediatly and the patients were soon free fron respirator and returned home.A 2.5-year-follow-up showed no recurrence in the first patient.Conclusion:Intratracheal insertion of stent is an effective way in treating tracheal stenosis.

Purpose:We observed and compared the therapeutic effects of CO_2 and dehy- drated ethanol as sclerosing agent,in percutaneous interventional methods for treatment of hepatic and renal cysts,Materials and methods:Twenty-two simple cysts,14 in livers,8 in kidneys,af- ter percutaneous puncture and aspiration,we instilled CO_2 or dehydrated ethanol into the cysts once, twice or thrice with followed-up for 2 to 29 months,Results:All the 22 cysts in 22 patients were better after treatment especially of them,including 8 of 12 cases(66.7%)treated with dehydrated ethanol only once.The maximum diameters of 8 renal cysts(8/8,100%)after one treatment re- duced to less than 2cm in the follow-up,comparing with only 5 of 14 hepatic cysts(5/14,35. 7%).Conclusion:1)Pereutaneous interventional method by guidance of ultrasound is safe and ef- fective in simple hepatic or renal cyst treatment.2)CO_2 is similar to dehydrated ethanol as a scleros- ing agent.3)The therapeutic effect of simple renal cyst is better than that of hepetic cyst.

Objective To evaluate the application of early 18F-FDG PET-CT imaging after radiofrequency ablation (RFA) of hepatic malignancies. Methods Fifteen patients with liver tumors (five hepatocellular carcinoma, ten colorectal cancer liver metastasis ) underwent RFA as part of clinical management. The lesions were all hypermetabolic on PET-CT performed within 2 weeks prior to RFA. All subjects underwent 18F-FDG PET-CT (early PET-CT) within 24 hours after RFA. Total photopenia, focal uptake, and rim-shaped uptake were regarded as complete ablation, residual tumor, and inflammation, respectively. Follow-up PET-CT scans were performed as the reference standard. Results Twelve patients showed total photopenia at the ablation site on the early PET-CT scan, and in all of these patients, total photopenia at the ablation sites was seen on the follow-up PET-CT scans. Two patients had focal uptake at the ablation sites on the early PET-CT scan, and both of these foci increased in size and intensity, which were compatible with residual tumors at the time of ablation. Only one patient had rim-shaped uptake on the early PET-CT scan. The rim-shaped uptake disappeared on PET-CT performed 3 months later, which indicated the nature of inflammation. Conclusions There is infrequent inflammatory uptake at the RFA site of liver tumors on 18F-FDG PET-CT if scanning is performed within 24 hours after ablation. Thus, early PET-CT has the potential to evaluate the efficacy of an RFA procedure by indicating tumor-free as total photopenia and residual tumors as focal uptake.

Objective To assess the value of MSCT in the follow-up of patients with small hepatocelluar carcinoma(sHCC) treated with RFA. Methods Twenty-eight patients with sHCC underwent MSCT scanning 1, 3 and 6 months after RFA. Results One month after RFA, 25 tumors were completely necrotized, among which 19 presented no enhancement on dual-phase contrast CT scans and 6 showed thin ring-shaped enhancement on artery-phase contrast. Three cases with residual tumor manifested as nodular enhancement in margin of lesion. Three and 6 months after RFA, all 25 tumors, which were completely necrotized, became small and presented no enhancement. New tumors were found in the liver in 2 cases six months after RFA. Conclusion RFA is an effective therapeutic method for sHCC, and MSCT dual-phase enhanced scanning is a good way for evaluating the curative effect and follow-up.

Objective To evaluate dynamic CT and PET-CT features of normal dog liver after radiofrequency ablation(RFA)correlated with the time-related histopathological changes.Methods Fifteen hybrid adult dogs in good health condition were evenly divided into 5 groups(the immediate,1 st,2 nd,4 th and 8 th week group)according to random digits table methods.Twice RFA was performed for each dog liver.The dogs after RFA underwent CT and PET-CT scanning respectively at the time point defined for each group.All dogs were executed through intravenous injection of klorvess liquid after scanning.Liver samples were histologically examined.All images were assessed to determine the ratios(r_(p/p))which referred to the comparison of rimlike enhancement or tracer uptake in the periphery of the necrosis to that in normal liver parenchyma.Those imaging results were compared and correlated with histopathological findings.Results For the immediate group after RFA procedure,central ablation lesions appeared coagulation necrosis and surrounding sinusoids engorged with blood.On the images of enhanced CT,marked rimlike enhancement was noticed in peripheral ablation lesions.While PET-CT showed decreased ~(18)F-FDG uptake surrounded by homogeneous tracer distribution.For the 1 st-4 th week group,central necrosis was gradually getting more severe.Infiltration of the inflammatory cells,granulation tissue formation and fibrous tissue restoration were noticed in peripheral ablation lesions.Rimlike enhancement and increased glucose metabolism appeared surrounding the lesions on CT and PET-CT,especially in the 1st to 2nd week groups.For the 8 th week group after RFA,the enhancement or hypermetabolism metioned above disappeared when perilesional tissue regeneration became more obvious.From the dynamic curve of changes on enhanced CT,marked enhancement occurred in the immediate group after ablation(r_(p/p)=1.34±0.21),reached its peak at the 1st week group(r_(p/p)=1.39±0.20),and then declined gradually.The metabolic changes on PET-CT showed a typical single peak curve,with the peak at the 1st week group(r_(p/p)=1.19±0.09)and similar even metabolism at the immediate and 8 th week group.Conclusions Both CT and PET-CT imaging can well correlate with the histopathological changes after RFA in the normal liver.To avoid the interference of inflammatory reaction when differentiating normal liver tissue from residual tumor,it is better to take radiology examination immediately and 8 weeks after RFA.PET-CT probably has advantages over CT immediately after RAF.After 1 week,PET-CT and CT may have similar diagnostic efficacy.

Whether in the world or China,lung cancer is a malignant tumor which is harmful to human health.There were studies showed that lung cancer is tightly related to the environment factors and life style.The epidemiology study found that eating more fruits and vegetables can prevent lung cancer.Vegetables and fruits are rich in phytochemicals such as isothiocyanates,indoles,flavonoids and so on.These phytochemicals reduce the risk of lung cancer by modulating antitumorrelated pathways such as inhibition of cell proliferation,induction of apoptosis,and the like.The aim of this review is to summarize the mechanisms of phytochemicals in vegetables and fruits in the pathogenesis and progression of lung cancer,so as to provide theoretical basis and direction for the prevention and treatment of lung cancer.

After decades of development,protein and peptide drugs have now grown into a major drug class in the marketplace.Target identification and validation are crucial for the discovery of protein and peptide drugs,and bioinformatics prediction of targets based on the characteristics of known target proteins will help improve the efficiency and success rate of target selection.However,owing to the developmental history in the pharmaceutical industry,previous systematic exploration of the target spaces has mainly focused on traditional small-molecule drugs,while studies related to protein and peptide drugs are lacking.Here,we systematically explore the target spaces in the human genome specifically for protein and peptide drugs.Compared with other proteins,both suc-cessful protein and peptide drug targets have many special characteristics,and are also significantly different from those of small-molecule drugs in many aspects.Based on these features,we develop separate effective genome-wide target prediction models for protein and peptide drugs.Finally,a user-friendly web server,Predictor Of Protein and Peptide drugs'therapeutic Targets(POPPIT)(http://poppit.ncpsb.org.cn/),is established,which provides not only target prediction specifically for protein and peptide drugs but also abundant annotations for predicted targets.