Improved manipulation of oblique-pulling (Ban) and fixed-position rotating pulling were applied to the patient with the prolapse of lumbar intervebral disc for reduction. Then acupuncture therapy, which used Shuigou (GV 26) and Weizhong (BL 40) as the main acupoints, was used. Totally 97 cases were treated, 58 cases were cured, 35 cases were improved, and 4 cases had no effect. The total effective rate was 95.5%.

Objective To study the clinical value of 18F-FDG PET/CT in childhood neuroblastoma (NB). Methods 18F-FDG PET/CT was performed in 31 children diagnosed with NB. According to the treatment conditions, patients were divided into pre-therapy group, radiation and chemotherapy group, postoperative group, respectively. The positive rate, sites, and im-age characteristics of the primary lesion and metastasis lesion were analyzed through qualitative and quantitative analysis of the image. Results Twenty-one (67.7%) and fourteen (45.2%) patients were found positive in primary sites by CT and PET respectively. All cases (9/9, 100%) in pre-therapy group were found positive in primary lesions by PET, 3 positive cases (75.0%) in radiation and chemotherapy group and 2 positive cases (11.1%) in postoperative group. Twenty-one patients showed metas-tases (67.7%). Lymph nodes (16 cases) and bone (bone marrow) (13 cases) were the most common sites of metastasis followed by pleura, meninges, liver and retrobulbar inifltration, all of which showed increased FDG uptake. Two patients were found lesions in lungs by CT, but had no FDG uptake. SUVmax of primary lesions was signiifcantly different among pre-therapy, chemotherapy and postoperative group (H=13.89, P=0.001), and pre-therapy group had the highest value. Metastases (lymph nodes, bone and bone marrow, pleura, liver and meninges) in pre-therapy group had high SUVmax. Conclusions NB primary tumors are characterized by the increased FDG metabolism. PET can fully detect the distribution of NB metastases in whole body. Except the pulmonary metastasis, metastases in other positions show increased FDG uptake. PET has potential role in evaluating the efifcacy of radiation and chemotherapy, and identifying postoperative residual or recurrence.

BACKGROUND: Although single gene can induce bone marrow mesenchymal stem cells (BMSCs) into chondrocyte, it still has limit action, polygene interaction accord with real demand of body internal environment and is helpful to play synergistic effect and to improve the differentiated effect.OBJECTIVE: To investigate the secretion of target gene and differentiation of BMSCs transfected by BOX-9 and insulin-like growth factor-1 (IGF-1) gene alone and together into chondrocytes.DESIGN, TIME AND SETTING: Two-specimen observation was conducted in the Cell Biological Laboratory of China Medical University between April 2008 and February 2009. MATERIALS: Two 6-week-old healthy male Wistar rats were used for the BMSCs extraction. METHODS: The plasmids pcDNA3.1-1GF-1 and pcDNA3.1- BOX-9 were amplified and extracted. BMSCs of Wistar rats were separated and purified. According to the transfect situation, the BMSCs were divided into 5 groups. ①Non-transfected group:serum-free and double-antibody-free L-DMEM; ②empty vector transfection group: serum-free and double-antibody-free L-DMEM + pcDNA3.1 empty vector and liposome; ③BOX-9 transfection group: serum-free and double-antibody-free L-DMEM +pcDNA3.1-SOX-9 plasmid and liposome; ④IGF-1 transfection group: serum-free and double-antibody-free L-DMEM+pcDNA3.1-1GF-1 plasmid and liposome; ⑤SOX-9 and IGF-1 transfection group: serum-free and double-antibody-free L-DMEM+ pcDNA3.1-1GF-1 plasmid and liposome, pcDNA3.1-SOX-9 plasmid and liposome.MAIN OUTCOME MEASURES: After being transfected, the cells were selected, the proliferation activity was tested by MTT and expression levels of target gene and protein were tested by RT-PCR and Western blot. RESULTS: The proliferation activity (A value) of BMSCs transfected by SOX-9 alone, iGF-1 alone, SOX-9 and IGF-1 together was significantly higher than that of BMSCs in the non-transfected group and empty vector trensfection group (P < 0.01). RT-PCR and Western blot result showed that SOX-9 expression was the highest in the group transfected by SOX-9, the expression of IGF-1 was the highest in the group transfected both by SOX-9 and IGF-1, and the expression of collagen Ⅱ was the highest in the group transfected both by SOX-9 and IGF-1.CONCLUSION: The double gene transfection is supedor to single transfection with regard to the differentiation of BMSCs to chondrocytes and the secretion of extracallular matdx. It is indirectly suggested that IGF-1 induces BMSCs to differentiate into chondrocytes, but the capacity is less than SOX-9.

Objective To summarize the 18F-FDG PET/CT findings of LCH in children,and explore its value in the diagnosis of LCH.Methods PET/CT imaging and clinical data of 13 patients (6 males,7 females;average age (3.0±2.3) years) with LCH confirmed by histology before treatment from August 2011 to December 2015 in Xin Hua Hospital were retrospectively analyzed.Results All 13 patients have different degrees of bone destruction with increased metabolism,the common lesion sites were craniofacial bone,spine,limb long bones,ribs/chest/shoulder blade and pelvic bone.Lymph node lesions which manifested lymph node enlargement with increased metabolism were found in 10 cases,and the SUVmax was 4.0±1.3.Diffuse FDG uptake in spleen was found in 10 cases.There were 4 cases with liver lesions,3 with lung lesions,1 with high metabolic nodules in muscle,1 with orbital lesions and 1 with intraspinal high metabolic nodules.Conclusion 18F-FDG PET/CT could display the distribution and activity of LCH,and plays an important role in the diagnosis and systemic evaluation of LCH.

Objective To assess the effect and influencing factors on 131I treatment for cervical lymph node metastasis (LNM) after operation in patients with PTC.Methods PTC patients (n =117;45 males,72 females;average age (45.17± 15.50) years) with postoperative cervical LNM from January 2010 to December 2014 were analyzed retrospectively.LNM was diagnosed by surgical pathology,imaging results and clinical follow-up.Single factor analysis was performed in age,gender,operation mode,TNM stage,131I treatment time and other factors.The results for 131I treatment effect included CR,PR,NC.Two-sample t test and x2 test were used.Results Among the 117 PTC patients with postoperative LNM,53 (45.3％) cases had non-131 I-avid metastasis.Fifty of the 64 (54.7％) patients with 131I-avid metastasis were treated with 131I.Nineteen patients (38.0％) achieved CR,22 (44.0％) achieved PR,and 9 (18.0％) showed invalid results.Fourteen of the 64 patients underwent another cervical lymph node dissection.Nine patients achieved CR,5 patients achieved PR,and 4 PR patients were then treated with 131I and finally achieved CR.Single factor analysis showed that the influencing factors of non-131I-avid lymph node included patients' age (t =3.459),serum Tg level (x2 =6.698) and metastasis with 1s F-FDG uptake (x2 =26.928;all P＜0.05).The influencing factors of 131I treatment effect included lymph node dissection procedure (x2 =6.487),unilateral or bilateral lesion (x2=5.187) and LNM size (x2=8.099;all P＜0.05).Conclusions 131I treatment is ineffective for nearly 50％ of patients with non-131I-avid LNM.The influencing factors of 131I treatment effect include the lymph node dissection procedure,unilateral or bilateral lesions and LNM size.

Objective To investigate the effect of arsenic trioxide on human coronary smooth muscle cells(HCSMCs). Method After the subculture of HCASMCs, cells were divided into 4 groups: control group and three arsenic trioxide (4.0 μmol/L) groups as the arsenic agent co-cultured with cells for 12,24 and 48 h. Flow cytometry and TUNEL were used for counting the ntmnber of cell apoptosis. RT-PCR was used to detect the expression of E2F-1 mRNA and Western blot was used to measure the levels of Bcl-2 ond Bax. Results Arsenic trioxide inhibited the proliferation of HCASMCs. When arsenic trioxide was 4.0 μmol/L, the living cells were ( 8.44 ±0.10) × 105/mL,signifiantly than that of control group (16.44 ± 1.34) × 105/mL, P ＜ 0.05. This inhibition of proliferation cycle was produced by affecting S and G2-M phase, which did not appear in the control group. Apoptotic cells increased from 16.0% ± 3.1% to 38.7% ± 2.7% (P ＜ 0.05) detected by TUNEL. The arsenic agnet decreased the Bcl-2 level and increased Bax. The expression of E2F-1 mRNA was decreased in 4.0 μmol/L arsenic trioxide group. Conclusions Arsenic trioxide exerts the apoptotic effect on human coronary smooth muscle cells.

Objective To investigate the apoptotic effects of arsenic trioxide on E2F-1 and EMAP-Ⅱ of hu-man coronary artery smooth muscle cells (HCASMCs). Method HCASMCs proliferated after culturing cells.Cells were divided into 4 groups: control group and arsenic trioxide (4.0μmol/L) 12 h group, 24 h group and 48 h group. Flow cytometry was used for counting number of apoptotic cells, RT-PCR was used for detecting the ex-pression of E2F-1 mRNA and Western blot was employed to get the level of EMAP-Ⅱ. Results Arsenic trioxide inhibited the proliferation of HCASMCs (living cells in 4.0 μmol/L arsenic trioxide were (8.44±0.10)×10~5/mL vs. control (16.44±1.34)×10~5/m (P <0.05), and the 4.0μmol/L arsenic trioxide inhibited proliferation cy-cle via affecting S and G2M phases, while those were not found in control group. E2F-1 mRNA expression was de-creased in 4.0 μmol/L arsenic trioxide group. Western blot test showed EMAP- Ⅱ level was also decreased in 4.0 μmol/L arsenic trioxide group. Conclusions Arsenic trioxide has apoptotic effect on smooth muscle cells of hu-man coronary artery and decrease the expression of E2F-1 mRNA and the level of EMAP- Ⅱ.

Objective To evaluate the clinical value of 18F-FDG PET/CT in preoperative assessment for endometrial cancer.Methods A retrospective study was performed in 51 patients (average age (59± 12) years) with confirmed or suspicious diagnosis of endometrial cancer from February 2013 to December 2015.Thirty-three patients underwent curettage surgery at least 1 week before PET/CT imaging.With SUVmax as the statistical variable,comparison was made between the pathologically confirmed benign and malignant groups,and in case of the latter,the extent of infiltration,histologic grade and subtype of primary tumor,lymph node and distant metastases were also analyzed.Two-sample t test was used to analyze the data,and diagnostic efficacy of PET/CT for metastasis was calculated.Results There were 43 patients with endometrial cancer and 8 patients with benign uterine tumor.SUVmax was found to significantly correlate with histopathology classification (benign:3.4 ± 1.2,malignant:12.8 ± 6.5) and depth of myometrial invasion (≥1/2:17.7±5.4,＜1/2:10.9±5.9;t=-8.7 and 3.2,both P＜0.05),but not with cervical stromal invasion,histologic grade or histologic subtype(t =1.8,-1.9,1.5,all P＞0.05).The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value (NPV) of PET/CT for the detection of lymph node metastases on a lesion basis were 85.7％ (18/21),98.2％ (271/276),97.3％ (289/ 297),78.3％(18/23),98.9％ (271/274),respectively,and on a patient basis were 6/6,97.3％ (36/ 37),97.7％ (42/43),6/7,100％ (36/36),respectively.The sensitivity and PPV of PET/CT for the detection of other metastases on a lesion basis were both 11/12.Conclusion SUVmax could be a clinically valuable tool for preoperative evaluation of the presence of deep myometrial invasion,lymph node metastases and other metastases in patients with endometrial cancer,particularly in specificity and NPV.

Objective To investigate the relationship of low level of high-density lipoprotein cholesterol to contrast induced-acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods A total of 1500 consecutive patients,who underwent PCI from January 2009 to May 2011,were enrolled in this study.There was no limit on age or sex,and all patients were self-identified as Han ethnic group.Patients were excluded from this study,however,if they had a history of malignant tumor,urinary tract infection,nephrectomy operation,chronic peritoneal or hemodialysis,or if they had been exposed to contrast media within the past 14 days.CI-AKI was defined as an absolute increase in serum creatinine ≥44.2 μmol/L or a relative ≥25％ increase in serum creatinine within 72 hours after procedure.Low level of HDL-C was defined as ＜ 1.04 mmol/L.Monofactorial and multivariate analysis was performed to identify risk factors for CI-AKI and low level of HDL-C in these patients.Results Among the 1500 patients with coronary heart disease,CI-AKI occurred in 246 patients after PCI and the overall incidence of CI-AKI was 16.4％.The patients with low level of HDL-C had a higher incidence of CI-AKI than those without it (21.5％ vs.13.3％ in total,P ＜0.01),no matter that they had suffered from chronic kidney disease (39.8％ vs.26.5％,P ＜ 0.05) or not (17.7％ vs.9.7％,P ＜ 0.01).By multivariate analysis,low level of HDL-C was identified as an independent risk factor for CI-AKI and smoke,great BMI as well as anemia were considered as prediction factors for low level of HDL-C.Conclusion The patients with low level of HDL-C have a higher incidence of CI-AKI after PCI.Low level of HDL-C is one of risk factors for CI-AKI after PCI in patients either with chronic kidney disease or not.Great BMI,smoking as well as anemia are independent predictors for low HDL-C level in these patients.