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Objective:To investigate the role of preoperative 18F-fluorodeoxyglucose (FDG) PET/CT imaging in mid-long-term prognosis of patients with resectable non-small cell lung cancer (NSCLC). Methods:Seventy resectable NSCLC patients (35 males, 35 females, median age 64 years) in Beijing Hospital between April 2010 and August 2016 were enrolled into this retrospectively study. All patients underwent 18F-FDG PET/CT imaging followed by pulmonary resection with mediastinal or hilar lymph nodes dissection within 1 month. The findings of PET/CT imaging including characteristics of primary lesions and mediastinal or hilar lymph nodes (size and maximum standardized uptake value (SUV max) of primary lesion, SUV max and distribution of high metabolic lymph nodes (HML)) were analyzed, and patients were followed up. Survival outcome indicators were defined as overall survival (OS) and progression-free survival (PFS). Survival analysis was conducted by Kaplan-Meier method, log-rank method and Cox proportional hazard models to assess the predictive factors. Results:Patients were followed up for 0.9-8.2 years. Among 70 patients, 31.4% (22/70) had disease progression and 24.3% (17/70) died. As for OS, there were significantly differences between patients with SUV max of primary lesion≥10 and <10 (4.6 vs 7.6 years), with size of primary lesion >3 cm and ≤3 cm (4.8 vs 7.4 years), with unilateral mediastinal or hilar HML and bilateral sides or without HML (4.4 vs 7.4 years), with SUV max of mediastinal or hilar lymph nodes ≥5.0 and <5.0 (3.8 vs 7.3 years) ( χ2 values: 10.135-15.238, all P<0.01), as well as PFS (3.9 vs 6.7, 3.8 vs 6.6, 3.8 vs 6.4, 3.3 vs 6.3 years; χ2 values: 8.410-14.600, all P<0.01). Cox multivariate analysis demonstrated that the size and SUV max of primary lesion were independent predictive factors of OS and PFS (all P<0.01). Moreover, the distribution of mediastinal or hilar HML had marginal significance in predicting OS ( P=0.051). Conclusions:Size and SUV max of primary lesion in preoperative 18F-FDG PET/CT imaging are predictive factors for the survival of postoperative NSCLC. The distribution of the mediastinal or hilar HML may have significance for the survival prediction of postoperative NSCLC.
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Objective To analyze the results of the final aviation medical examination of 1281 students recruited into Air Force youth aviation schools in Hunan and Hubei provinces in order to provide reference for establishing the items and standards of medical selection .Methods The data of 1281 students who participated in final aviation medical examination of Air Force youth aviation schools in 2016 were collected , who came from 28 cities in the above two provinces .The disqualification rate and related unqualified medical items were calculated , and the differences of the disqualification rate and medical geographical areas in the 28 cities were analyzed .Results According to the disqualification rate , the top five departments were ophthalmology , otolaryngology, surgery, radiology and ultrasonic departments .The top 10 unqualified items were the lack of distant vision , fundus diseases , nasal anomaly , ametropia and strabismus , spine abnormality , audition abnormality, vestibular function badness , vitreous opacity, and lens abnormalities.There was no significant difference between the 28 cities in the disqualification rate (P >0.05) or between the two provinces (P >0.05). Conclusion The results of the final aviation medical examination reflect the quality and efficiency of the initial aviation medical examination .To improve the quality of medical selection , further research is needed to set a scientific standard for the initial aviation medical examination while strengthening the scientific protection and intervention of distant vision .The efficiency of selection depends on improving the accuracy of initial aviation medical examination in nasal cavity structure, body shape ,and lens opacity .With a better understanding of the disqualification rate and abnormal items in different cities , a scientific arrangement of professional staff and technical force can make the initial aviation medical examination better, thus effectively reducing the rate of false elimination rate and misdiagnosis .
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Objective To compare the medical selection standards of flying cadets in the nervous and mental system between Air Force of PLA(PLAAF) and the US Air Force(USAF), and to offer suggestions on revising PLAAF medical standards for flying cadets .Methods All our candidates who had participated in the final medical selection of flying cadets were subjected to neurological examinations , and determined as qualified or not according to USAF Medical Standards Directory.Results 123 people were disqualified during the neurological examination , accounting for 1.1% of the total. According to USAF Medical Standards Directory , 13 of them were disqualified , 24 of them were qualified , and 86 of them needed a second examination .There was marked difference between disqualification rates of PLAAF and USAF .Conclusion There are some differences in medical selection standards for flying cadets in the nervous and mental system between PLAAF and USAF, and we could revise PLAAF standards using USAF standards for reference .
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Objective To investigate the role of poly(ADP-ribose) polymerase (PARP) inhibitor PJ34 in regulating blood-brain barrier (BBB) permeability and matrix metalloproteinases-9 (MMP-9) expression in a mouse model of traumatic brain injury (TBI).Methods A total of 136 adult male BALB/c mice were randomly divided into sham-operated group,injured group and PJ34-treated group according to the random number table.Controlled cortical impact in mice was established.At 6 and 24hours postinjury,neurological deficit was evaluated,including motor,sensory,reflex and beam balance tests ; BBB permeability and brain water content were detected using Evans blue test and gravimetric technique; brain contusion volume was measured using HE staining; levels of MMP-9 in cytosolic fractions were detected using Western blotting.Results At 6 and 24 hours postinjury,neurological severity score in PJ34-treated group (8.00 ± 0.26,7.50 ±0.25) were lower than those in injured group (12.50 ±0.39,11.80 ± 0.32) ; brain contusion volume in PJ34-treated group [(11.25 ± 0.91) mm3,(13.55 ±1.06) mm3] was lower than those in injured group [(25.37 ± 1.75) mm3,(28.24 ± 1.51) mm3] ; BBB permeability in PJ34-treated group [(440.08 ± 3.10) μg/mg,(860.46 ± 3.86) μg/mg] was lower than those in injured group [(936.96 ± 4.71) μg/mg,(1 302.23 ± 5.89) μg/mg] (all P ＜ 0.01).Brain water content lowered significantly in PJ34-treated group than in injured group at 6 hours postinjury [(80.77 ± 0.76) ％ vs (82.55 ± 0.73) ％,P ＜ 0.0l],but between-group difference was not significant at 24 hours postinjury.Lower levels in MMP-9 were also observed in PJ34-treated group compared with injured group at 6 and 24 hours postinjury(P ＜ 0.05 or 0.01).Conclusion PARP inhibitor PJ34 can attenuate MMP-9 up-regulation,inhibit BBB injury and hence protect the brain against TBI in mice.
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Objective To investigate the clinical features of internal carotid steal syndrome. Methods The clinical manifestations, CT or MRI, digital subtraction angiography, and blood flow compensation in 6 patients with internal carotid steal syndrome were analyzed. Results Of the 6 patients, 2 had unilateral internal carotid artery stenosis, 4 had severe stenosis (in which 2 were on the left side, 1 was on the right side, and 1 was on both sides). The clinical manifestations of the patients with internal carotid steal syndrome were watershed infarction and transient ischemic attack. Four patients had posterior circulation ischemia and 2 had anterior circulation ischemia. Digital subtraction angiography demonstrated that collateral circulation was established in all the 6 patients. The anterior communicating artery, posterior communicating artery, and pial artery were the common compensatory vessels. Conclusions Internal carotid artery steal syndrome can be presented as anterior or posterior circulation ischemia, and the collateral circulation plays an important role in the compensation.
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Low self-certainty of patient satisfaction evaluation in patient satisfaction survey is found in the survey to be the main cause for the failure that satisfaction scores cannot precisely indicate the correct satisfaction level of patients for medical services received; it is stated in the study that psychological bias in the survey can be reduced by means of reasonable choice of survey scenario, clear notice of survey's objective, and independent completion of survey questionnaire by the patients; it also stated the theoretic references and research clues in studying patient satisfaction uncertainty, as a mathematic model is built for such study, for the purposes of better advancement of the theoretic study and practice of patient satisfaction.
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Objective: To investigate the case-mix method by clinical pathway. Methods: K-MEANS cluster analysis was applied to case-mix classification and artificial neural network was used for case-mix prediction. Results: Five hundred and twenty three inpatient records constructed a case-mix classification scheme of 4 groups.Statistical significant difference of costs existed in 4 groups.The training error of artificial neural network was low(0.0 029) and the predicting result was accurate(98.91%). Conclusion: Case-mix result was more reasonable using records under clinical pathway.The existing models of case-mix depend on dividing individual variables, but artificial neural network does not.