Volume 87  ·   Issue 28  ·  2007

Colorectal cancer is the most common malignant tumor in humans. Compared with the 10 years before and after 1990, the incidence rate of colorectal cancer in urban areas in China increased by 31.18% and 17.51% in rural areas; In the same period, the annual incidence rate decreased by 1.5% in men and 1.3% in women in the United States, forming a significant contrast [1]. In terms of clinical treatment, about 40% ~50% of patients with bowel cancer failed in hospital with conditions, among which metastasis and recurrence were the main cause of treatment failure, and liver was the most common and most prone to metastasis.

The distribution of the incidence of colorectal cancer in all regions of the world has a significant characteristic: the incidence of colorectal cancer in all countries and regions with high industrialization degree, such as North America and Australia, is at a very high level; The incidence rate of colorectal cancer in some areas with rapid industrialization in recent years, such as Japan, Hong Kong and Korea, has increased rapidly, and some of them have even reached the level of high incidence countries; While economically underdeveloped regions such as Africa and most countries in Central and South America have an incidence of less than 10/100 000 [1].

Objective to systematically evaluate the efficacy and safety of selective cyclooxygenase (COX) -2 inhibitors in the prevention of colorectal adenoma. Methods Medline (1966 to 2006) database, OVID (1996 to 2007) database, EMBASE (1980 to January 2007) database, Cochrane Library (until January 2007) and Chinese Biomedical Literature Database (CBM disk, 1997 to January 2007) database were searched. The quality of randomized controlled studies (RCT) was evaluated according to Jadad quality score. Meta-analysis was performed with RevMan4.2 software. Results A total of 5708 patients in 6 randomized clinical trials met the inclusion criteria. Compared with placebo, selective COX-2 inhibitors significantly reduced the detection rate of adenoma (RR: 0.70, 95% CI: 0.55 to 0.88, P =0.0003) and the detection rate of advanced adenoma (RR: 0.69, 95% CI: 0.53 to 0.89, P =0.005). There was no significant difference in the risk of adverse reaction between the two patients (RR: 1.07, 95% CI: 0.98 to 1.17, P =0.11), Not yet available for routine medication.

Objective to investigate the role of CpG island methylation of the promoter of secreted Wnt antagonist gene in colorectal tumorogenesis.Methods 5-aza-2'-deoxycytidine (DAC) and tricocin A (TSA) were used to demethylate colorectal cancer cell lines HCT116 and SW480. Methyl specific PCR and reverse transcription PCR were used to detect the methylation and mRNA expression of secreted frizz-associated protein (sFRP) and Wnt inhibitor factor 1 (WIF-1) in colorectal tumor tissues and cell lines, respectively.Results sFRP and WIF-1 genes were not methylated in normal colorectal mucosa. The methylation rates of sFRP1,2,4,5 and WIF-1 in colorectal adenocarcinoma were 93.1% (67/72), 83.3% (60/72), 36.1% (26/72), 52.8% (38/72) and 84.7% (61/72), respectively; 87.9% (29/33), 81.8% (27/33), 24.2% (8/33), 57.6% (19/33), 72.7% (24/33) of adenomas, respectively; The normal tissues were 52.6% (20/38), 28.9% (11/38), 2.6% (1/38), 18.4% (7/38) and 23.7% (9/38) respectively; The methylation rates of sFRP1, 2, 4 and 5 in degenerative recesses (ACF) were 94.4 (17/18) %, 77.8% (14/18), 27.8% (5/18) and 55.6% (10/18), respectively. The methylation of sFRP and WIF-1 gene was not related to the clinicopathological characteristics of colorectal adenocarcinoma and adenoma (P>0.05). The CpG islands of sFRP1, 2, 4, 5 and WIF-1 gene promoters were all hypermethylated in HCT116 cell line. Only sFRP1, 2 and WIF-1 were methylated in SW480 cell line. The mRNA of methylated gene was not expressed or decreased; Conclusion Methylation of Wnt antagonist gene is a common early event in colorectal tumors, and methylation of sFRP1, 2, 5 and WIF-1 may be a biological marker for early detection of colorectal tumors.

Objective to investigate the epidemiological characteristics of colorectal cancer in community population of Guangdong Province. Methods A total population of 100,859 in five towns of Huidong County, Guangdong Province was selected on July 1, 2005. The total crude incidence rate of colorectal cancer in community population of Guangdong Province was 15.2/100,000 (17.2/100,000 men and 13.0/100,000 women), and the standardized incidence rate was 17.6/100,000 (19.5/100,000 men and 16.7/100,000 women). The crude incidence rate was 41.9/100,000 (46.5/100,000 men and 37.2/100,000 women), and the standardized incidence rate was 49.0/100,000 (54.1/100,000 men and 45.6/100,000 women). The crude mortality rate was 5.0/100,000 (5.9/100,000 men and 4.0/100,000 women), and the standardized mortality rate was 6.4/100,000 (7.2/100,000 men and 5.7/100,000 women).

A 66-year-old male was found to have an 8.1 cm ×6.2 cm ×4.2 cm heterogeneous echo nodule in the lateral fat sac of the left kidney with unclear boundary, up and down movement with breathing, and lack of abundant blood flow. The patient occasionally felt left iliac discomfort. There was no history of tuberculosis, hematuria and urinary tract infection in the past. There was no obvious abnormality in physical examination and no special in laboratory examination. CT examination showed that the left kidney was enlarged in volume, irregular in shape, and slightly displaced forward and upward.

Objective to investigate the correlation between serological markers of hepatitis B virus (HBV) and HBV DNA. Methods HBV DNA was detected by quantitative PCR internal standard method, and 100 cases of chronic hepatitis B patients with normal alanine aminotransferase (ALT) /aspartate aminotransferase (AST) and HBV DNA positive without interferon and nucleoside (acid) analogue treatment were screened out. The serological markers of hepatitis B were detected by microparticle enzyme immunoassay and ELISA. 40 healthy people were screened as quality control controls. Results HBV DNA positive hepatitis B patients: (1) The positive rate of hepatitis B e antigen (HBeAg) was 75%; The positive rate of hepatitis B e antibody (anti-HBE) was 25%; The positive rate of hepatitis B pre-S1 antigen (PreS1-Ag) was 69%; The positive rate of pre-hepatitis B S2 antigen (PreS2-Ag) was 77%; (2) Among the 75 HBeAg positive patients, 54 cases were positive for PreS1-Ag and 60 cases were positive for PreS2-Ag; Among the 25 anti-HBE positive patients, 14 were positive for PreS1-Ag and 17 were positive for PreS2-Ag. There was no statistically significant difference in the positive rates of PreS1-Ag and PreS2-Ag (both P>0.05). (3) When HBeAg was positive, the negative rate of both PreS1-Ag and PreS2-Ag (8%) was lower than that of anti-HBe (28%), and the difference was statistically significant (P<0.05); (4) PreS1-Ag and PreS2-Ag were both positive and negative in 72 cases. Conclusion The coincidence rate of HBeAg, PreS1-Ag, PreS2-Ag positive and HBV-DNA positive is high in patients with chronic hepatitis B. There is no clear correlation between the positive rates of PreS1-Ag and PreS2-Ag and the positive rate of HBeAg. There is a good correlation between the negative rates of PreS1-Ag and PreS2-Ag and the positive rate of anti-HBe.

Objective to observe the changes of Janus kinase 3 (JAK3) mRNA expression in peripheral blood mononuclear cells after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to investigate the relationship between Janus kinase 3 (JAK3) mRNA expression and graft versus host disease (GVHD). Methods Fluorescence quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) was used to monitor the JAK3 mRNA expression in 83 peripheral blood mononuclear cells of 26 patients after allo-HSCT. Results GVHD was not observed in 14 patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT), the median level of JAK3/ABL mRNA was 8.71 in 14 patients, the median level of JAK3/ABL was 31.94 in 1 patient with acute GVHD (aGVHD), and the level of JAK3/ABL was 19.23 in 11 patients with chronic GVHD (cGVHD).

Objective to evaluate the effect of specific human leukocyte antigen (HLA) class Ⅱ antibody on the long-term survival of renal transplantation after renal transplantation. Methods A prospective cohort study was conducted to detect the level of specific HLA class Ⅱ antibody during perioperative period by enzyme-linked immunosorbent assay (ELISA) in 118 patients with renal transplantation. Results (1) Survival analysis showed that the survival rate of HLA class Ⅱ antibody positive group was significantly lower than that of antibody negative group in the third and fourth years (78.6% vs 84.4% in the third year, 71.4% vs 80.0% in the fourth year, P =0.002); After excluding the death factors, the survival rate of transplanted kidney in the HLA-Ⅱ antibody positive group was still lower than that in the antibody negative group (85.7% vs 92.2% in the third year, 82.1% vs 90.0% in the fourth year, P =0.003). (2) The rate of decline of transplanted kidney function in the HLA-Ⅱ antibody positive group in the third and fourth years was higher than that in the antibody negative group (39.3% vs 33.3% in the third year, 46.4% vs 38.9% in the fourth year, P =0.001). (3) There was no significant difference in the incidence of late acute rejection between the HLA-Ⅱ antibody positive group and the HLA-Ⅱ antibody negative group (10.7% vs 13.3%, P>0.05). Conclusion Postoperative specific HLA-Ⅱ antibody may be one of the important factors affecting the long-term survival of transplanted kidney.

Objective to summarize and evaluate the long-term clinical effect of orthotopic enterocystectomy.Methods 126 cases of bladder cancer who underwent total cystectomy orthotopic enterocystectomy were followed up from January 1989 to 2001, and the data were collected and analyzed.Among them, 84 cases underwent orthotopic ileal bladder replacement, 42 cases underwent orthotopic bladder replacement with sigmoid colon; 62 cases underwent intraoperative lymph node dissection and 64 cases underwent postoperative radiotherapy and chemotherapy. The postoperative urine control rate, complication rate, tumor recurrence rate and 5-year survival rate of patients in different groups were compared respectively. Results 122 cases were followed up completely. The ureteral dilatation and reflux rate of sigmoid colon group were higher than that of ileum group (80.9% vs 32.1%, 23.8 vs 2.4%, P<0.05), and the nighttime urine control rate of sigmoid colon group was higher than that of ileum group (P<0.05); The postoperative tumor recurrence rate in lymph node dissection group was lower than that in chemoradiotherapy group (P<0.05), and the 5-year survival rate was higher than that in chemoradiotherapy group (P<0.05). The incidence of short-term complications was 15.9% (20/126), and the incidence of long-term complications was 9.8% (12/122).

Objective to investigate the interaction between adiponectin and various metabolic abnormalities in non-diabetic males with coronary heart disease. Methods the subjects were studied in the Department of Cardiology, Zhongshan Hospital affiliated to Fudan University. The subgroups of non-diabetic males were analyzed. 127 cases in the coronary heart disease group and 88 cases in the control group were age-matched contrast negative. The physical parameters, biochemical indexes and serum adiponectin were measured. The correlation between adiponectin and various metabolic risk factors was analyzed by partial correlation analysis, and the relationship between adiponectin, metabolic abnormalities and coronary heart disease was analyzed by Logistic multiple stepwise regression analysis. Results The age of the subjects was 59 ± 9 years old. The concentration of adiponectin in the non-diabetic males with coronary heart disease group was lower than that in the control group [7.9 (5.7~11.6) mg/L vs 10.0 (7.0~13.5) mg/L, P =0.014]. Partial correlation analysis showed that the concentration of adiponectin was negatively correlated with triglyceride (TG), total cholesterol (TC), blood glucose (PPG2 h), body mass index (BMI) and metabolic abnormality score after age control (r-0.250, Adiponectin remained negatively correlated with TC and TG (r-0.170 and-0.193, respectively, both P<0.05). Logistic multiple stepwise regression analysis showed that TG and adiponectin concentration were independently correlated with coronary heart disease (OR 2.277 and 0.533, respectively). Conclusion Adiponectin was affected by abnormal metabolic accumulation, and high adiponectin was a protective factor against coronary heart disease.

Objective to study the gene sequence characteristics of gag-pol region in human immunodeficiency virus/AIDS patients in Liaoning Province. Methods Proviral DNA was extracted from peripheral venous blood of 99 HIV-1 infected patients in Liaoning Province. The 2.6 kb fragment of gag-pol region was amplified by nested PCR method. A phylogenetic tree was constructed together with the reference sequence of subtypes in HIV S sequence database to distinguish the subtypes, and the gene dispersion rate and Ks/Ka ratio of different coding regions of gag-pol region were calculated. Results Five subtypes of A, B ', B, C and G were found in 99 HIV-1 infected patients in Liaoning Province. The five circulating recombinant types were CRF01_AE, CRF03_AB, CRF06_cpx, CRF07_BC and CRF08_BC, and the recombinant ICR07/08 among the circulating recombinant types. The B' subtype was the most common, followed by CRF01_AE. In the gag-pol region, the gene dispersion rate of p17 and p2-p6 regions was higher than that of p24, protease and reverse transcriptase coding regions, but the gene dispersion rate of p24 region of subtype B was at a higher level. The gene dispersion rate, synonymous substitution and missense substitution of CRF07_BC and CRF08_BC in each gag-pol region were generally at a lower level. The Ks/Ka value of p2-p6 region of each subtype strain was the lowest, its mean value was<1, while the Ks/Ka value of RT region of CRF01_AE strain was as high as 10.45. Conclusion The subtypes of HIV-1 gag-pol region in Liaoning Province are very complex. The coding regions of p24, protease and reverse transcriptase are more conserved regions. The p24 region of subtype B strain was under a greater positive selection pressure, while the RT region of CRF01_AE strain was under a greater negative selection pressure. The introduction time of CRF07_BC and CRF08_BC into Liaoning Province was short, and the founder effect was obvious.

Objective to detect the mutation of RET proto-oncogene in a family of multiple endocrine neoplasia type 2A (MEN2A), in order to explore the molecular mechanism of the pathogenesis of the family. Methods A family of MEN2A, including 22 members of two generations of probands, extracted the peripheral blood genomic DNA of 22 members of the family, amplified the exons 10 and 11 of the proband's RET proto-oncogene, and then directly sequenced the purified PCR products, and further cloned and sequenced to determine the mutation sites and the changes of encoding amino acid sequences. After detecting the exons where the mutations were located, the amplified products of the corresponding exons of other patients and their relatives were sequenced. Results There was heterozygous deletion of D631 codon (GAC) in all 4 MEN2A patients, and the base sequence changed from TGC^GACGAGCTG to TGCGAGCTG, resulting in the deletion of D631 representing aspartic acid, namely delD631. Among 4 patients, the first-degree relative of Ⅱ6 (Ⅲ10) was the carrier of this gene mutation. Conclusion D631 heterozygous deletion mutation in exon 11 exists in MEN2A family in this study, which is the first reported D631 deletion mutation in RET proto-oncogene at home and abroad. Clinical characteristics: Compared with cysteine site mutation, the onset age of adrenal pheochromocytoma is later than that of medullary thyroid carcinoma.

Objective to study the effect of persistent atrial fibrillation (AF) on autonomic nerve.Methods Dog model of persistent atrial fibrillation was prepared by rapid pacing.After stopping pacing, the heart rate variability (HRV) was evaluated after conversion to sinus rhythm. Then the content of norepinephrine in left and right atrial appendages, left and right atrial free walls and interatrial septal myocardium was measured. The expression of nerve growth factor protein and β 1 receptor in myocardium was also studied.Results After the formation of persistent atrial fibrillation, sympathetic nerve tone increased. The low frequency component (LF) of ms2 in long-term atrial fibrillation group (1682 ± 362) and short-term atrial fibrillation group (1247 ± 219) was higher than that in normal control group (798 ± 154) ms2 (P<0.01), while the high frequency component (HF) of ms2 in long-term atrial fibrillation group (232±75) and short-term atrial fibrillation group (310±165) was lower than that in normal control group (1041 ± 195) ms2 (P<0.01). The difference was statistically significant (P<0.01). The expression of nerve growth factor protein in atrial muscle increased, and the expression of β 1 receptor was down-regulated in atrial fibrillation group.Conclusion Persistent atrial fibrillation caused the increase of cardiac sympathetic tone and the heterogeneous accumulation of norepinephrine in atrial muscle, which may be mediated by NGF.

Objective to investigate the feasibility of establishing pulmonary surfactant-superoxide dismutase (PS-SOD) liposomes carrying SOD for transport to rat lung tissues. Methods PS-SOD liposomes were prepared by modified rotary evaporation method. Thirty-two Wistar rats were randomly divided into four groups: normal saline control group, PS group, SOD group and PS-SOD liposome group, 8 rats in each group. Each group was directly injected with normal saline, PS, SOD and PS-SOD liposomes through the main trachea, respectively. Each group was further divided into two subgroups, 4 rats in each group, and were sacrificed at 2 h and 24 h after operation, respectively. RESULTS PS-SOD liposomes were single-layer lipid membrane round bodies with stable properties. At 2 h, the activity of SOD in lung lavage fluid in PS-SOD liposome group and SOD group (32.87 ± 5.47, 33.14 ± 5.61) was higher than that in normal saline group (2.15 ± 0.17, both P<0.01), but the difference between the two groups was not statistically significant (P>0.05); The mean fluorescence optical density of PS-SOD liposome group (0.109±0.018) was significantly lower than that of normal saline group and PS group (0.144±0.052, 0.143±0.026, both P<0.01); There was no significant difference in mean optical density of fluorescence between PS-SOD liposome group and SOD group (P>0.05). At 24 h, the activity of SOD in lung lavage fluid in PS-SOD liposome group (11.54±1.42) was higher than that in normal saline group (2.10±0.21) and SOD group (6.28±1.45, both P<0.01). The mean optical density of fluorescence in PS-SOD liposome group (0.112±0.018) was significantly lower than that in the other three groups (normal saline group: 0.146±0.034, PS group: 0.147±0.024, SOD group: 0.135±0.018, both P<0.01). No matter 2 h or 24 h, the activity of SOD in lung homogenate in PS-SOD liposome group (16.83±2.69 and 15.70±2.75) was higher than that in normal saline group (5.79±0.93 and 5.84±1.31, both P<0.01), but there was no significant difference between SOD group and normal saline group (P>0.05), and the activity of SOD in lung homogenate in PS-SOD liposome group was significantly higher than that in SOD group (7.07±1.04, 6.11±1.06, both P<0.01).

Objective to investigate the distribution and expression of protein kinase C (PKC) -β Ⅰ,β Ⅱ in kidney of diabetic nephropathy (DN) mice and the effect of angiotensin receptor antagonist telmisartan on it. Methods Eighteen mice were randomly divided into normal group, DN group and treatment group (TG group). The expressions of PKC-β Ⅰ, β Ⅱ, transforming growth factor (TGF-β 1) and vascular endothelial growth factor (VEGF) in glomerulus were detected by semi-quantitative immunofluorescence technique, and the distribution and expression of PKC-β Ⅰ and β Ⅱ in renal tissue were detected by laser confocal and immunoblotting technique. Results Compared with the normal group, the expression of PKC-β Ⅰ and-β Ⅱ in proximal convoluted tubular epithelial cells was stronger in DN mice, while the expression of PKC-β Ⅱ in cortex and inner medullary collecting duct epithelial cells disappeared. The expression of PKC-β 1 in the renal cortex and external medulla of DN mice was higher (P<0.01), while the expression of PKC-β Ⅱ in the renal cortex was significantly lower (P<0.01). Semi-quantitative immunofluorescence further showed that the expression of PKC-β Ⅰ, TGF-β 1 and VEGF in the glomeruli of DN mice was significantly higher than that in the normal group (up-regulated 0.48, 0.20 and 0.24 times, respectively, all P<0.01), while the expression of PKC-β Ⅱ was down-regulated 0.27 times (P<0.05). The expression of PKC-β 1 was positively correlated with TGF-β 1 (r =0.649, P =0.030) but not with VEGF (r =0.387, P =0.079), and the expression of PKC-β Ⅱ was not correlated with TGF-β 1 and VEGF (r =0.387, P =0.079). Telmisartan can partially correct the above changes. Conclusion (1) The expression and distribution of PKC-β Ⅰ and β Ⅱ in the kidney tissue of DN mice changed, suggesting that they were involved in the function of proximal convoluted tubules of DN, and PKC-β 1 may affect the expression of TGF-β 1 in glomeruli

Objective to investigate whether small amounts of adenovirus as helper virus can enhance the transduction efficiency of adeno-associated virus (AAV) to tumor cells and nude mouse tumor models, and to investigate the mechanism of the enhancement. Methods AAV2 labeled with green fluorescent protein (EGFP) and different titers of non-replicating adenovirus (Ad-null) were used to infect human non-small cell lung cancer cell lines (AAV2+ Ad-null group), and the same dose of AAV2 alone (AAV2 group) was used as control. The EGFP-positive cells were observed by fluorescence microscope, the percentage of EGFP-positive cells and the average fluorescence intensity of individual cells were detected by flow cytometry, and the changes of EGFP protein expression were detected by Western blot to compare the transduction efficiency of each group. The transduction efficiency of AAV2 labeled with luciferase (Luc) was detected by Luc detection system. The relative copy number of EGFP in DNA and mRNA of tumor cells after infection was detected by fluorescence quantitative PCR, and the effect of Ad-null on AAV2 The number of EGFP-positive cells in the AAV2+ Ad-null group increased significantly. The EGFP-positive cell rates in the AAV2+ Ad-null group were 10.9%, 18.0%, 36.2% and 55.2% at 0.01, 0.1, 1 and 10 MOI Ad-null titers, respectively, which were significantly higher than those in the AAV2 group (6.4%). The fluorescence intensity of single cell in the AAV2+10 MOI Ad-null group was about 1.32 times that in the AAV2 group. The EGFP protein expression level in each AAV2+ Ad-null group was also higher than that in the AAV2 group. In vitro and in vivo Luc detection showed that Ad-null significantly enhanced the transduction efficiency of AAV2 to tumor, and the fluorescein signal was 28 and 4.5 times that of AAV2 alone, respectively. Ad-null could increase the mRNA level of AAV2 in tumor cells. When Ad-null titers were 1 and 10 MOI, the EGFP copy number in the AAV2+ Ad-null group was significantly higher than that in the AAV2 group, while Ad-null had little effect on the DNA of AAV2 in cells.

The malignant degree of adrenocortical carcinoma (ACC) is very high, the prognosis is very poor, and the incidence rate is about (1~2) /1 million [1-2]. Although the research on ACC has made some progress in the auxiliary examination and molecular level in recent years, and many clinicians have applied various therapeutic methods in clinic, because ACC is relatively rare, there is still a lack of sufficient data to evaluate the natural history of this disease and the efficacy of various therapeutic methods.

In 1966, Gabbay et al. [1] proposed the role of polyol pathway and its enhanced activity in the pathogenesis of diabetic peripheral neuropathy, which revealed the molecular mechanism of diabetic complications for the first time. Subsequently, it was discovered that the increase of non-enzymatic glycosylation end product (AGE), the enhancement of protein kinase C (PKC) activity and the increase of hexosamine pathway are related to the pathogenesis of diabetic complications.

Objective to introduce the surgical method of endoscopic resection of inferior slope chordoma and to explore the application value of endoscopy in the surgery of inferior slope chordoma. Methods Three cases of inferior slope chordoma were resected by endoscope-guided oral-pharyngeal posterior wall approach. Results Postoperative MRI showed total resection in 2 cases and subtotal resection in 1 case; There were no serious complications and no sequelae after operation. The patients were followed up for 6 months to 2 years. One patient died 1 year after surgery, and two patients survived without tumor. Conclusion Endoscope-guided transoral-pharyngeal posterior wall approach to resection of inferior clival chordoma has the advantages of short surgical route, little damage to surrounding tissue structure, quick recovery after surgery, and no serious complications and sequelae. Especially, endoscopy with different angles of view can show and remove the lesions located in the hidden anatomical area that other surgical methods cannot show, which is more conducive to the thorough resection of tumor, and is a better surgical method for resection of lower slope chordoma.

Objective to predict the therapeutic response of patients with malignant lymphoma (ML), and to determine whether the expression of multidrug resistance gene (MDR1) and multidrug resistance-related protein (MRP) gene can be accurately evaluated according to the imaging parameters of methoxy isobutyl isonitrile (99Tcm-MIBI). Methods Twenty-three patients with ML confirmed by lymph node biopsy were examined by 99Tcm-MIBI before chemotherapy, and the target (T/B) ratio of early image (10 min) and late image (1 h) and the elution rate (WR%) of 99Tcm-MIBI developer were calculated respectively; The expression levels of MDR-1 and MRP mRNA were detected by reverse transcription (RT) -PCR. After 6~8 courses of combined chemotherapy (with or without local radiotherapy), the therapeutic response of lymphoma patients was evaluated by clinical and radiological methods.Results The WR% (16±6) of patients with negative expression of MDR1 and MRP mRNA was significantly lower than that of both positive expression groups (33±5) and one positive expression group (28±6, both P<0.01); There was no significant difference between the two simultaneous positive expression groups and one of the two positive expression groups (P =0.26). The early image T/B value, late image T/B value and WR% in the MDR1 positive group were 3.0±1.1, 2.5±0.8, 17±7, and the three values in the MDR1 negative group were 3.4±1.0, 2.3±0.7, 32±6, respectively. Compared with the negative group, there was no significant difference in early image T/B and late image T/B in the MDR1 positive group (all P>0.05), but the difference in WR% was statistically significant (P<0.01). The three values of MRP positive group were 3.1±1.2, 2.5±0.8, 19±8, and MRP negative group were 3.3±1.0, 2.3±0.7, 31±6, respectively. Compared with the MRP positive group, only the difference in WR% was statistically significant (P =0.003), but the difference in early image T/B and late image T/B was not statistically significant (all P>0.01). There was a significant correlation between MDR1 expression level and WR% and treatment response (all P<0.01). Conclusion 99Tcm-MIBI, as a non-invasive imaging method, can accurately reflect the expression level and functional status of MDR1 and MRP, and can predict the chemotherapy efficacy of patients with ML. It is beneficial to adopt targeted individualized treatment strategy.

A 70-year-old male, farmer, was admitted to hospital in April 2004 for cough and sputum accompanied by fever for 2 months. He had a history of hypertension and cerebral thrombosis. He smoked for 50 years, 2 packs a day. Two weeks ago, he had a cold and cough, yellow and sticky phlegm, occasionally bloodshot, fever up to 38.2℃, shortness of breath, and chest discomfort during activity.

The patient was a 40-year-old driver who was admitted to the hospital on August 1, 2005 due to "hemoptysis for 5 days". The patient had hemoptysis without obvious inducement 5 days before admission, which was bright red, about 30 ml. He went to the local hospital immediately. Chest radiographs showed no abnormalities, and improved after symptomatic treatment. Three days ago, hemoptysis of about 200 ml appeared again, and lung CT showed a flaky shadow of the right upper lung, and abdominal CT showed bilateral low-density adrenal gland focuses, which were considered tumors. Symptomatic management continued. Two hours before admission, hemoptysis of about 200 ml appeared, slight dizziness, no headache, no fear of cold and fever, no night sweats, no cough and expectoration, no chest tightness and shortness of breath, no chest pain, no palpitations.

The patient was a 28-year-old female, married and childbearing. Intermittent dull pain in the left lumbar area for more than 1 year. Physical examination showed percussion pain in the left kidney area (+). B-ultrasound examination showed dilation of the left renal pelvis and ureter, stones in the lower calyx of the left kidney (5mm ×5mm) and mild effusion in the left kidney.

optical coherence tomography (OCT) is a technique used to measure the structure of living tissue in medicine, which is equivalent to the optical microscopy of tissue section in pathological histology; However, instead of surgically obtaining specimens for examination, it is directly performed on the human body.