Background and purpose:The radio-labeled glucose analogue F-18-fluoro-2-deoxyglucose(FDG) is the most widely used tracer in PET imaging,and its application in oncology has become one of the standard imaging modalities.But FDG uptake is not tumor specifi c.The aim of this paper was to study the endoscopic result with the patients of 18F-FDG accumulations in gastrointestinal tract after PET-CT examinations.Methods:Thirtythree patients with 18F-FDG accumulations in gastrointestinal tract were correlated with endoscopic and histopathologic results.Results:Of these,14 patients were harboring newly occurring cancers in gastrointestinal tract(esophagus cancer,2 patients;gastric cancer,5 patients;colorectal cancer,7 patients) .Eight patients were identified with precancerous lesions(adenoma,4 patients;hyperplastic polyp,1 patient;Barrett’s esophagus,1 patient;intestinal metaplasia of the gastric mucosa,2 patients) .Inflammatory lesions were detected in six patients(active colitis,5 patients;anastomotic leakage,1 patient) .In fi ve patients,PET/CT showed normal fi ndings in endoscopic examinations.The false positive rate of PET-CT was 33.33%(11/33) .Conclusion:Endoscopic result is important for patients of 18F-FDG accumulations in gastrointestinal patient.

Background and purpose: Currently endoscopic ultrasonography is clinically accepted for preoperative staging of gastric cancers. Endoscopic raucosai resection (EMR) and endoscopic subraucosal dissection (ESD) have been widely applied in the treatment of early gastric cancer. We need to improve the accuracy of pre-operative staging of gastric cancers, especially of early gastric cancers. This paper was to investigate the clinical significance of high frequency endoscopic ultrasound mini probe (UMP) in the preoperative T-staging of gastric cancer. Methods: Both UMP and MSCT were performed in 63 patients with pathologically proven gastric cancer frora Oct. 2008 to Apr.2009, and the results of UMP and MSCT were compared with surgical pathologic findings. Results: The accuracy of UMP and MSCT in T staging was 82.26% (51/62) and 88.71% (55/62) respectively, and there was no statistical difference (P>0.05). The accuracy of UMP and MSCT for early gastric cancer was 100.00% and 88.89% respectively.The accuracy of UMP and MSCT for advanced gastric cancer was 79.25% and 88.68% respectively. Conclusion: UMP appears to have a substantial diagnostic value for early stage gastric cancer. It is the approach of choice for superficial lesions.

Objective:To investigate the correlation between inositol level and glycolipid metabolism in gravidas with gestational diabetes mellitus (GDM).Methods:A cross-sectional study was conducted on 80 GDM cases undergoing routine examination at Fujian Provincial Maternity and Children's Hospital from November 2018 to August 2019, who were selected as GDM groups. Another 50 women with uncomplicated pregnancies during the same period were selected as the control group. Blood and urine inositol level and serum glycolipid profiles were compared between the two groups, and their association was analyzed. Independent or paired-sample t test, Mann-Whitney test, Chi-square (or Fisher's exact) test, and Pearson correlation test were performed for statistical analysis. Results:The serum inositol concentration and high-density lipoprotein (HDL) cholesterol in the GDM group were significantly lower [322.1 ng/ml (279.1-364.1 ng/ml) vs 403.8 ng/ml (391.8-425.3 ng/ml), Z=-7.879; 1.8 mmol/L (1.5-2.0 mmol/L) vs 2.0 mmol/L (1.7-2.2 mmol/L), Z=-2.419; both P<0.05], while the concentration of urine inositol, lipoprotein-a (lipo-a), 0 h-, 1 h-, 2 h-oral glucose tolerance test (OGTT) glucose, fasting insulin, and glycosylated hemoglobin (HbA1c) were significantly higher when comparing to the control group [192.2 ng/ml (171.0-219.9 ng/ml) vs 143.8 ng/ml (121.1-158.6 ng/ml), Z=-6.834; 253.2 mg/L (65.0-349.0 mg/L) vs 148.5 mg/L(46.5-159.3 mg/L), Z=-0.187; 5.0 mmol/L (5.1-5.6 mmol/L) vs 4.4 mmol/L (4.2-4.6 mmol/L), Z=-5.547; 10.0 mmol/L (9.1-11.3 mmol/L) vs 7.8 mmol/L (7.0-8.4 mmol/L), Z=-6.987; 8.6 mmol/L(7.6-9.4 mmol/L) and 6.6 mmol/L (5.7-7.1 mmol/L), Z=-7.100; 18.2 mU/L(10.6-25.9 mU/L) vs 11.0 mU/L (6.3-12.7 mU/L), Z=-4.537; 5.4%(4.5%-5.5%) vs 5.1%(4.9%-5.4%), Z=-3.468; all P<0.05]. (2) Serum inositol concentration was negatively correlated with fasting insulin and 0 h-, 1 h-, 2 h- OGTT glucose level ( r=-0.386, -0.416, -0.350 and -0.407, respectively); urinary inositol concentration was positively correlated with 0 h-, 1 h-, 2 h-OGTT glucose levels ( r=0.402, 0.389 and 0.429, respectively) (all P<0.05). Conclusions:Serum inositol concentration was decreased, and urinary inositol excretion was increased in women with GDM. Measurement of changes in inositol levels during the second trimester may be helpful to assess the metabolic status of pregnant women.

Objective:To compare the efficacy and safety of olaparib in combination with pembrolizumab with pembrolizumab alone in second-line treatment for patients with extensive stage-small cell lung cancer (ES-SCLC) whose ages ranged from 40 to 80 years.Methods:From March 2017 to October 2019, 21 patients with progressed or relapsed small cell lung cancer after standard first line treatment were enrolled in this study. The olaparib/pembrolizumab group ( n=11) was treated by olaparib 300mg twice per day combined with pembrolizumab 200mg once every 3 weeks, while pembrolizumab group was treated by pembrolizumab alone. Results:The objective response rate (ORR) of olaparib/pembrolizumab group and pembrolizumab group were 45.5% and 10.0%, respectively ( P=0.149), and the disease control rate (DCR) were 81.8% and 70.0% ( P=0.635). The median progression-free survival (PFS) were 5.93 months and 3.53 months ( P=0.036), the median overall survival (OS) were 10.43 months and 8.43 months ( P=0.063). The adverse reaction incidences of all grades were 90.9% and 70.0% ( P=0.311), and the incidences of grade Ⅲ-Ⅴ including myelosuppression were 36.4% and 10.0% ( P=0.311), gastrointestinal reaction were 9.1% and 10.0%, ( P=1.000) and other immune-related adverse events were 18.2% and 30.0% ( P=1.000). Further analysis showed the metastatic number ( P=0.006), platinum sensitivity ( P=0.036) and LDH level ( P=0.022) significantly affected the ORR of olaparib/pembrolizumab therapy. Conclusion:Our preliminary study indicates that olaparib combined with pembrolizumab is an efficient and safe second-line treatment therapy for patients with ES-SCLC.

Objective:To compare the efficacy and safety of olaparib in combination with pembrolizumab with pembrolizumab alone in second-line treatment for patients with extensive stage-small cell lung cancer (ES-SCLC) whose ages ranged from 40 to 80 years.Methods:From March 2017 to October 2019, 21 patients with progressed or relapsed small cell lung cancer after standard first line treatment were enrolled in this study. The olaparib/pembrolizumab group ( n=11) was treated by olaparib 300mg twice per day combined with pembrolizumab 200mg once every 3 weeks, while pembrolizumab group was treated by pembrolizumab alone. Results:The objective response rate (ORR) of olaparib/pembrolizumab group and pembrolizumab group were 45.5% and 10.0%, respectively ( P=0.149), and the disease control rate (DCR) were 81.8% and 70.0% ( P=0.635). The median progression-free survival (PFS) were 5.93 months and 3.53 months ( P=0.036), the median overall survival (OS) were 10.43 months and 8.43 months ( P=0.063). The adverse reaction incidences of all grades were 90.9% and 70.0% ( P=0.311), and the incidences of grade Ⅲ-Ⅴ including myelosuppression were 36.4% and 10.0% ( P=0.311), gastrointestinal reaction were 9.1% and 10.0%, ( P=1.000) and other immune-related adverse events were 18.2% and 30.0% ( P=1.000). Further analysis showed the metastatic number ( P=0.006), platinum sensitivity ( P=0.036) and LDH level ( P=0.022) significantly affected the ORR of olaparib/pembrolizumab therapy. Conclusion:Our preliminary study indicates that olaparib combined with pembrolizumab is an efficient and safe second-line treatment therapy for patients with ES-SCLC.

This study was performed to explore the effect of flagellin+rapamycin on the growth and metastasis of 4T1 breast cancer in tumor-bearing mice,and their regulatory effect on several immunocytes.4T1 cell line was applied to establish an breast cancer model in Balb/c mice,which then injected with flagellin+rapamycin,and the volume and inhibition rate of tumor were recorded.MTT assay was used to detect the inhibitory effect of flagellin+rapamycin against 4T1 cells.Data showed that the combination of flagellin and rapamycin had the best inhibition effect on 4T1 cells,and the same results were found in animal model experiments.Flow cytometry result indicated that flagellin+rapamycin significantly down-regulated the levels of CD11b+Gr-1+myeloid-derived suppressor cells(MDSCs)and CD11b+F4/80+tumor-associated macrophages(TAMs)of tumor-bearing mice.Furthermore,flagellin+rapamycin alleviates the metastasis of 4T1 cancer cells into liver and lung.Taken together,flagellin+rapamycin can inhibit proliferation and metastasis of 4T1 cells,thus exert antitumor effects in mice,which may related with its regulatory effects on immunocytes in tumor microenvironment.

Objective:To investigate the effects of continuous renal replacement therapy (CRRT) on plasma concentration, clinical efficacy and safety of colistin sulfate.Methods:Clinical data of patients received with colistin sulfate were retrospectively analyzed from our group's previous clinical registration study, which was a prospective, multicenter observation study on the efficacy and pharmacokinetic characteristics of colistin sulfate in patients with severe infection in intensive care unit (ICU). According to whether patients received blood purification treatment, they were divided into CRRT group and non-CRRT group. Baseline data (gender, age, whether complicated with diabetes, chronic nervous system disease, etc), general data (infection of pathogens and sites, steady-state trough concentration, steady-state peak concentration, clinical efficacy, 28-day all-cause mortality, etc) and adverse event (renal injury, nervous system, skin pigmentation, etc) were collected from the two groups.Results:A total of 90 patients were enrolled, including 22 patients in the CRRT group and 68 patients in the non-CRRT group. ① There was no significant difference in gender, age, basic diseases, liver function, infection of pathogens and sites, colistin sulfate dose between the two groups. Compared with the non-CRRT group, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) were higher in the CRRT group [APACHE Ⅱ: 21.77±8.26 vs. 18.01±6.34, P < 0.05; SOFA: 8.5 (7.8, 11.0) vs. 6.0 (4.0, 9.0), P < 0.01], serum creatinine level was higher [μmol/L: 162.0 (119.5, 210.5) vs. 72.0 (52.0, 117.0), P < 0.01]. ② Plasma concentration: there was no significant difference in steady-state trough concentration between CRRT group and non-CRRT group (mg/L: 0.58±0.30 vs. 0.64±0.25, P = 0.328), nor was there significant difference in steady-state peak concentration (mg/L: 1.02±0.37 vs. 1.18±0.45, P = 0.133). ③ Clinical efficacy: there was no significant difference in clinical response rate between CRRT group and non-CRRT group [68.2% (15/22) vs. 80.9% (55/68), P = 0.213]. ④ Safety: acute kidney injury occurred in 2 patients (2.9%) in the non-CRRT group. No obvious neurological symptoms and skin pigmentation were found in the two groups. Conclusions:CRRT had little effect on the elimination of colistin sulfate. Routine blood concentration monitoring (TDM) is warranted in patients received with CRRT.