177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To investigate the clinical value of serum monocyte/high-density lipoprotein ratio (MHR) level in the diagnosis of coronary heart disease(CHD).Methods:A total of 127 patients who underwent coronary angiography in the cardiology department of the Third Hospital of Changsha were enrolled as subjects. Patients with coronary artery stenosis ≥50% were included in the CHD group ( n=97), and patients with coronary artery stenosis <50% were included in the control group ( n=30). According to the clinical classification of CHD, the patients were divided into stable angina group ( n=31), unstable angina group ( n=35) and acute myocardial infarction group ( n=31). The general clinical data of the selected cases were collected, and the serum MHR, myeloperoxidase (MPO) and high sensitivity C-reactive protein (hs-CRP) were detected. The degree of coronary artery lesions was scored by Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) score system, and the number of coronary artery lesions was counted. The relationship between MHR level, MPO, hs-CRP and the degree of coronary artery stenosis in CHD group was analyzed. The MHR level of CHD was divided into three subgroups by triquartile: the differences of SYNTAX score and the number of coronary artery lesions were compared in the low MHR group (≤0.41, n=40), the middle MHR group (0.410.48, n=27). The value of serum MHR in diagnosing CHD was analyzed by receiver operating characteristic (ROC) curve. The risk factors of CHD were analyzed by multivariate logistic regression. Results:(1) The serum MHR level in CHD group was higher than that in non-CHD group ( P<0.001). In different clinical subgroups of CHD: the levels of serum MHR were significantly higher in acute myocardial infarction group than unstable angina group and stable angina group ( P<0.001). (2) There was a positive correlation between serum MHR, MPO level with SYNTAX score in CHD group ( r=0.878, 0.477, 0.285, all P<0.001). (3) The SYNTAX score in high MHR group was higher than those in middle MHR and low MHR group; the SYNTAX score in middle MHR group was higher than that of low MHR group ( P<0.001); There was no significant difference in the number of coronary artery lesions among the three MHR level subgroups ( P>0.05). (4) Multivariate logistic regression analysis showed that LDL-C ( OR=1.107, 95% CI: 0.974-1.259), MHR ( OR=1.873, 95% CI: 1.352-2.496) were independent risk factors for CHD (all P<0.05). (5) ROC curve showed that the area under the curve of MHR in diagnosing CHD was 0.987, and the sensitivity was 82.8%. Conclusions:Serum MHR level is higher in patients with CHD, which is closely related to the severity of coronary artery disease and is an independent risk factor of CHD.

Objective To evaluate carotid sinus block (CAS) in preventing the low hemodynamic state in the perioperative period of carotid artery stenting (CAS).Method A prospective single-center randomized controlled study was conducted on 172 patients with internal carotid artery stenosis receiving CAS from May 2015 to May 2018.Patients were randomly divided into group A treated with local anesthesia of the carotid artery sinus of the trouble side under the guidance of ultrasound preoperatively and group B without local block anesthesia.The carotid artery stenosis rate,the maximum intraoperative reduction of blood pressure and heart rate,the use of atropine and vasopressor were monitored and compared between the two groups.Results There were no significant differences between the two groups in preoperative general data,degree of stenosis,plaque nature,degree of residual stenosis (P ＞ 0.05).The maximum reduction of intraoperative blood pressure and heart rate in group A was significantly lower than that in group B,and the number and dose of intraoperative atropine were smaller than those in group B (P ＜ 0.05).The number of postoperative patients with low hemodynamic status in group A and the time period of vasopressor use were significantly less than those in group B (P ＜ 0.05).Conclusion Preoperative carotid sinus block anesthesia is safe and effective in preventing low hemodynamic status in perioperative period of CAS.

Pace of life and work of people is accelerating nowadays, and hospitals keep improving their services, which gives rise to the decoction and delivery service from the third party vendors for traditional Chinese medicine(TCM).Given the quality control standards for the TCM decoction service as issued by Zhejiang and other regions, the systems of supervision and assessment remain incomplete.Authors of the paper introduced a project improvement team, composed of Chinese medicine pharmacy, Chinese medicine experience specialists, vendors of Chinese medicine decoction and express delivery companies, hence establishing a " three-in-one" supervision system of Internet+TCM decoction and delivery service. This practice can optimize the assessment indexes, strengthen the assessment system of assessment transformation and supervision system for patient medication.It proves that the practice contributes to higher quality and safety of TCM decoction and delivery service, improves the ability and level of TCM services, and ensures the medication safety of patients.

Objective To investigate the correlation between tumor-associated macrophages (TAMs) and the development of high risk human papilloma virus (hr-HPV)-related cervical cancer. Methods A total of 112 cases of cervical tissue were collected, including 16 normal cervical tissues, 55 cervical intraepithelial neoplasia (CIN) tissues and 41 squamous cervical cancer (SCC) tissues. The expression of CD163+ macrophages in the cervical tissues was detected by immunohistochemical method, and the results were analyzed in relation with the clinical data of the patients. Results Immunohistochemical analysis showed that the cell density of CD163+macrophages increased progressively with the increase in the tissue malignancy, in the order of normal cervical tissue, CIN I, CIN II-III, and SCC. Correlation analysis revealed a positive relationship between CD163 + macrophage density and tissue malignancy (P=0.000). The density of CD163 + macrophages was significantly upregulated in HR-HPV-positive SCC tissue (P<0.05). CD163+ macrophages were positively correlated with cervical lymph node metastasis (P=0.005) and FIGO stage (P=0.004) of SCC. Conclusion The expression of CD163+macrophages is positively correlated with malignant transformation of cervical tissues, and hr-HPV infection is significantly correlated with CD163 expression level in the macrophages. CD163+ macrophages can be used as predictors of the occurrence and progression of cervical cancer caused by hr-HPV infection.

Objective To investigate the correlation between tumor-associated macrophages (TAMs) and the development of high risk human papilloma virus (hr-HPV)-related cervical cancer. Methods A total of 112 cases of cervical tissue were collected, including 16 normal cervical tissues, 55 cervical intraepithelial neoplasia (CIN) tissues and 41 squamous cervical cancer (SCC) tissues. The expression of CD163+ macrophages in the cervical tissues was detected by immunohistochemical method, and the results were analyzed in relation with the clinical data of the patients. Results Immunohistochemical analysis showed that the cell density of CD163+macrophages increased progressively with the increase in the tissue malignancy, in the order of normal cervical tissue, CIN I, CIN II-III, and SCC. Correlation analysis revealed a positive relationship between CD163 + macrophage density and tissue malignancy (P=0.000). The density of CD163 + macrophages was significantly upregulated in HR-HPV-positive SCC tissue (P<0.05). CD163+ macrophages were positively correlated with cervical lymph node metastasis (P=0.005) and FIGO stage (P=0.004) of SCC. Conclusion The expression of CD163+macrophages is positively correlated with malignant transformation of cervical tissues, and hr-HPV infection is significantly correlated with CD163 expression level in the macrophages. CD163+ macrophages can be used as predictors of the occurrence and progression of cervical cancer caused by hr-HPV infection.

Objective To establish a HPLC method for simultaneous determination of oleanolic acid and ursolic acid and provide the basis for quality control of Hawthorn extract .Methods Chromatographic separation was performed on Agilent Zorbax SB C18 column(250 mm × 4 .6 mm ,5 μm) with mobile phase of methanol (A)-0 .06 mol/L ammonium acetate solution (B) (85∶15 ,V/V ) under isocratic elution for 30 min .The flow rate was set at 0 .8 ml/min and the detection was set at the wavelength of 210 nm .Results Oleanolic acid and ursolic acid showed good linearity (r> 0 .999 5) in the ranges of 0 .496-2.480 g and 0 .498-9 .960 g ,respectively .Repeatability ,precision ,recovery and stability were conform to the method valida-tion requirements of China Pharmacopoeia .Conclusion The method could provide the basis for the quality control of Hawthorn extract and its preparation .

Objective The incidence of complications after esophageal cancer surgery is relatively high.The purpose of this paper was to explore the feasibility of combined thoraco-laparoscopy surgical treatment for senile esophageal cancer(over 70 years old).Methods A total of 526 esophageal cancer cases were retrospectively analyzed in this study.The operative procedures was esophageal carcinoma resection surgery and thoracic and abdominal lymphadenectomy which were operated through video-assisted by thoracoscope and laparoscopic From January 2010 to June 2014 in the Union Hospital of Fujian Medical University,divided into aged groups(≥70 years old,n =132) and non-aged group(＜ 70 years old,n =394).Statistical analysis was carried on the rate of two groups of preoperative risk factors(hypertension,diabetes,cardiac insufficiency,pulmonary insufficiency,cerebral infarction),surgical trauma and the number of lymph node dissection (laryngeal recurrent nerve injury,operation time,intraoperative blood loss),postoperative complications(cardiac complications,chylothorax,pulmonary complications,anastomotic fistula,poor healing of the incision,intrathoracic stomach atony),postoperative recovery and early postoperative mortality.Results Preoperative risk factors:the prevalence of the aged group with hypertension,cerebral infarction,cardiac insufficiency,and pulmonary insufficiency was significantly higher than the non-aged group (P ＜ 0.05) but diabetes (P ＞ 0.05).Surgical trauma and the number of lymph node dissection:no significant difference (P ＞ 0.05).Postoperative complications:the aged group was higher in the incidence of pulmonary complications and cardiac complications than the other (P ＜ 0.05) ; but the chylothorax,anastomotic fistula and poor healing of incision,intrathoracic stomach atony in the two groups seemed no significant difference(P ＞ 0.05).Furthermore,pulmonary complications were highest in the all complications,significantly higher than the others in both groups.Postoperative recovery:significant difference existed in postoperative hospitalization days,the aged group was obviously longer than the non-age groups.Early postoperative mortality rates in the two groups had no significant difference.Conclusion The aged patiences had a higher prevalence in the preoperative risk factors and so was the cardiac complications as well as pulmonary complications among the postoperative complications.However the combined thoraco-laparoscopy in the surgical treatment of elderly patients with esophageal cancer is safe and feasible.

Objective To investigate the prevalence of physical state of HPV-l6 DNA in cervical cancer and cervical precancerous carcinoma. Methods Multiplex PCR was adopted to detect the physical state of HPV in samples from 252 patients with cervical carcinoma, including 48 samples of cervical cancer, 204 cervical intraepithelial neoplasia (CIN ) (125 CIN I, 46 CIN II and 33 CIN III) and 20 normal samples from the subjects with hysteromyoma undergoing hysterectomy, respectively. Results Among 48 patients with cervical cancer, 31 (65.6%) were infected with HPV-16. Eighteen among 31 (58.1%) HPV-16 infected patients with cervical cancer were found to have integrated infection of HPV-16. The positive rates of HPV-16 infection in the patients with CIN I, CIN II and CIN III were 19.2%, 34.8%and 42.4%, and the integrated infection rates of HPV-16 were 16.7%, 18.8%and 35.7%, respectively. Compared with patients with different grades of CIN, the integrated rate of HPV-16 infection in those with cervical cancer was significantly elevated. Conclusion Among the patients with HPV-16 infection, the integrated state of HPV-16 is positively correlated with the severity of cervical lesions. Combined HPV typing test and detection of integrated viral state contribute to predicting the prognosis of patients with cervical precancerous lesions and increasing the accuracy of screening cervical cancer on the basis of HPV DNA detection.

Objective To investigate the prevalence of physical state of HPV-l6 DNA in cervical cancer and cervical precancerous carcinoma. Methods Multiplex PCR was adopted to detect the physical state of HPV in samples from 252 patients with cervical carcinoma, including 48 samples of cervical cancer, 204 cervical intraepithelial neoplasia (CIN ) (125 CIN I, 46 CIN II and 33 CIN III) and 20 normal samples from the subjects with hysteromyoma undergoing hysterectomy, respectively. Results Among 48 patients with cervical cancer, 31 (65.6%) were infected with HPV-16. Eighteen among 31 (58.1%) HPV-16 infected patients with cervical cancer were found to have integrated infection of HPV-16. The positive rates of HPV-16 infection in the patients with CIN I, CIN II and CIN III were 19.2%, 34.8%and 42.4%, and the integrated infection rates of HPV-16 were 16.7%, 18.8%and 35.7%, respectively. Compared with patients with different grades of CIN, the integrated rate of HPV-16 infection in those with cervical cancer was significantly elevated. Conclusion Among the patients with HPV-16 infection, the integrated state of HPV-16 is positively correlated with the severity of cervical lesions. Combined HPV typing test and detection of integrated viral state contribute to predicting the prognosis of patients with cervical precancerous lesions and increasing the accuracy of screening cervical cancer on the basis of HPV DNA detection.