Myelodysplastic syndromes(MDS) are heterogeneous clonal stem cell disorders.There are about 40 ％-60 ％ MDS patients with abnormal karyotype.To analyze the clone category is not only useful for diagnosis and evaluating prognosis,but also helpful for the selection of optimal therapy strategies to improve the treatment efficacy.

Objective To discuss clinical characteriistics of APE and therapeutic effect of thrombolysis or anticoagulation so as to reduce false or misdiagnosis rate and improve survival rate.Methods The clinical data of 122 inpatients with APE were reviewed.Results The most common risk factors were deep venous thrombosis,age over 60 years old,cardiac disease,surgical operation,diabetes,fracture,long-term immobilization,etc.The most frequent symptom was dyspnea.D-dimmer measure had high sensitivity.By means of color Doppler echocardiography,spiral computed tomography,pulmonary ventilation/perfusion scanning,the cases were finally diagnosed.Positive treatment of thrombolysis and anticoagulation could reduce mortality.Conclusion As clinical manifestations of APE are non-specific,clinician should be alert.D-dimmer measue could be screening.The standardized treatment can improve prognosis significantly.

Objective: To explore the value of histogram features based on plain and enhanced CT for differential diagnosis of benign and malignant thyroid nodules. Methods: A total of 132 patients with 140 thyroid nodules confirmed by postoperative pathology were retrospectively analyzed. The level with the largest axial focus was selected, and then Mazda software was used to sketch ROI along the edge of focus and perform histogram analysis to obtain 9 parameters. The parameters were compared between benign and malignant nodules, and then statistically significant gray-scale histogram parameters were used to analyze their value of differentiating benign and malignant thyroid nodules. Results: On plain CT, the mean value, the 10th, 50th and 90th percentiles of malignant nodules were higher than those of benign ones (all P<0.05), while on enhanced CT, the mean value, variance, and the first, 10th, 50th and 90th percentiles of malignant nodules were all higher than those of benign ones (all P<0.05). The average value of malignant nodules was higher than that of benign ones by the first, 10th, 50th and 90th percentage points, and the variance of benign group was higher than that of malignant group (all P>0.05). Among the parameters of CT plain and enhanced histogram, the 10th percentile AUC was the highest of 0.68, and the sensitivity of identifying benign and malignant thyroid nodules was 74.32%,and specificity was 62.12%. Conclusion: CT histogram analysis can be used as an important auxiliary means to identify benign and malignant thyroid nodules.

OBJECTIVETo explore the effect of glimepiride on the glucose uptake as well as glucose transporter (GLUT)-1 and GLUT-3 expression levels of rat mandibular osteoblasts in hyperglycemia.

METHODSPrimary osteoblasts were isolated and cultured. Then, the cells were placed in an osteogenic medium containing two glucose concentrations (5.5 and 16.5 mmol X L(-1)), with or without glimepiride (10 micromol x L(-1)). Glucose uptake was determined by employing 18F-deoxyglucose (18F-FDG) in the cells, and GLUT-1 and GLUT-3 expression levels were evaluated by Western blot analysis.

RESULTSGlucose at 16.5 mmol x L(-1) significantly inhibited 18F-FDG uptake and downregulated GLUT-3 protein expression in osteoblasts. Hyperglycemia increased GLUT-1 protein expression. Glimepiride significantly increased glucose uptake and upregulated GLUT-1 and GLUT-3.

CONCLUSIONGlimepiride enhance the glucose transporter in rat osteoblasts at two different glucose concentrations.

Objective To evaluate the impact of different factors on long-term results in cervical carcinoma patients initially treated by surgery followed by radiotherapy. Methods In 1998, 525 cervical carcinoma patients were admitted, among whom 346 patients were first treated by surgery. 302 of these 525 patients were given postoperative radiotherapy. The stage distribution of these 302 patients were: stage I 142;stage Ⅱa 121;stage Ⅱb 23;and stage Ⅲa 16. ~ 60 Co ? or 6MV X-ray was used for radiotherapy. Perpendicular portals were alternately irradiated to 44-50Gy/4-5 week. Extending the portal, increasing the dose after constricting portal, adding intracavitary afterloading irradiation and adjuvant chemotherapy were carried out according to the different clinical requirements. Results The 5-year survival rate was 89.4%,77.7%,56.5% and 56.3% in stage I, Ⅱa, Ⅱb and Ⅲa lesion, respectively(?~2=22.22,P

Objective To observe the clinical effects of external application of Chinese medicine ion introduction through acupiont in the prevention and treatment of hyperamylasemia and pancreatitis following endoscopic retrograde cholangio pancreatography (ERCP). Methods Three hundred subjects were divided into treatment group and control group randomly, and treated with routine therapy after surgery, moreover, treatment group was treated with external application of Chinese medicine ion introduction through acupiont. The incidence of hyperamylasemia and pancreatitis, the time of serum amylase returned to normal in patients with hyperamylasemia and pancreatitis was observed, and the abdominal pain after ERCP was scored. Results Excluding 17 cases according to the exclusion criteria, the treatment group included 142 cases and the control group included 141 cases. The hyperamylasemia and pancreatitis happened less frequently in the treatment group than in control group, but there was no significant difference (P>0.05). The time of serum amylase returned to normal in patients with pancreatitis was (4.25±0.95)d in treatment group and (5.28±1.11)d in control group, with no significant difference (P>0.05). The time of serum amylase returned to normal in patients with hyperamylasemia was (2.88 ± 0.78)d in treatment group and (3.81±1.62)d in control group, showed a significant difference (P<0.05). The score of abdominal pain was 0.95±1.04 in treatment group and 1.21±1.12 in control group, showed a significant difference (P<0.05). Conclusion External application of Chinese medicine ion introduction through acupoint can promote the recovery of the patients postoperative ERCP combined with hyperamylasemia or pancreatitis, and can better alleviate abdominal pain.

Objective To analyze the diagnostic value of MSCT and MRI in detecting the distal third of tibia shaft fracture complicated with occult posterior malleolar fracture.Methods One hundred and fifty-one patients with the distal third of tibia shaft spiral fracture underwent X-ray examination.For patients without posterior malleolar fracture on X-ray,MSCT and MR imaging were further performed.A binomial test was used to evaluate the significance of the differences between MSCT and MRI in the detection of posterior malleolar fractures and cortical involvement.Results A total of 126 (83.4％) in 151tibia shaft fracture were found to be associated with posterior malleolar fracture.Twenty-seven ( 21.4％ ) cases with posterior malleolar fracture were detected on X-ray.MSCT and MR examination were performed in 124 cases.Ninety-nine posterior malleolar occult fractures were detected on MRI,which included 81cases showed on MSCT.The sensitivity,specificity and accuracy of posterior malleolar occult fracture on MRI were 100％ (99/99),100％ (25/25) and 100％ ( 124/124),while they were 81.8％ (81/99),100％ (25/25)and 85.5％ (106/124) for MSCT respectively.The accuracy of posterior malleolar occult fracture on MRI was significant higher than MSCT ( Z =2.56,P =0.01).Seventy-eight cortical fractures were found on MSCT among 99 posterior malleolar occult fractures,while 51fractures were found on MRI.The sensitivity,specificity and accuracy of cortical fracture involvement were 100％ (78/78),100％ (21/21) and 100％ ( 99/99) for MSCT,while they were 65.4％ (51/78),100％ (21/21) and 72.7％ (72/99) for MRI respectively.The accuracy of cortical fracture involvement on MSCT was significant higher than MRI ( Z =4.02,P =0.00).Conclusions MRI has a higher accuracy than MSCT in detecting the distal third of tibia shaft fracture complicated with occult posterior malleolar fracture,while MSCT has a higher accuracy than MRI in detecting cortical fracture involvement.

Objective To investigate the effect of methylprednisolone on T helper 17 cell (Th17 cells) related cytokines (interleukin (IL)-23,17A,21,22,6,and tansforming growth factor (TGF)-β) in serum and cerebrospinal fluid from patients with relapsing remitting multiple sclerosis and their effects on the pathogenesis.Methods We recruited relapsing remitting multiple sclerosis group (38 patients)and noninflammatory neurological disease group (20 controls),and detected the levels of IL-23,IL-17A,IL-21,IL-22,TGF-β and IL-6 in serum and cerebrospinal fluid (CSF) with ELISA kit in both controls and patients before and after treatment by methylprednisolone.Results After treatment in relapsing remitting multiple sclerosis patients,IL-17A,IL-23,IL-21,and IL-22 levels in cerebrospinal fluid and serum were significantly decreased,however,they were still higher than that in the non-inflammatory neurological disease patients.TGF-β levels was significantly increased (serum:(17.2 ± 5.9) pg/ml vs (34.1 ± 6.5) pg/ml,t =14.351,P =0.000 ; CSF:(26.4 ± 4.7) pg/ml vs (73.2 ± 19.7) pg/ml,t =16.352,P =0.000).The levels of TGF-β in serum and CSF in patients before treatment were lower than those of in non-inflammatory neurological disease patients (serum:(30.2 ± 8.9) pg/ml,t =6.769,P =0.012 ; CSF:(3 1.4 ± 7.5) pg/ml,t =9.368,P =0.017).However,the levels of TGF-β in CSF in patients after treatment were significantly higher than those in non-inflammatory neurological disease patients (t =9.138,P =0.000).Correlation analysis showed that IL-23 and IL-17A were positive correlation in the serum of relapsing remitting multiple sclerosis patients before treatment.Moreover,positive correlations among IL-23,IL-17A and IL-21 were detected in the CSF of relapsing remitting multiple sclerosis patients before treatment.Conclusions Decreased levels of IL-23,IL-17A,IL-21 and IL-22,and elevated levels of TGF-β were detected in serum and CSF of patients with relapsing remitting multiple sclerosis after methylprednisolone treatment.IL-23,IL-17A,IL-21,IL-22 and TGF-β might involve in the pathogenesis of relapsing remitting multiple sclerosis.

Objective To investigate the relationship between the levels of adiponectin and leptin in umbilical bloods and fetal' s growth and development. Methods Eighty-six neonates bom in our obstetrics department from October 2006 to October 2007 were enrolled the study. According to different birth weight they were divided into small for gestational age infants (SGA) group( n = 16), appropriate for gestational age (AGA) group( n = 41) and large for gestational age (LGA) group ( n = 29 ). After the baby was delivered, 20ml umbilical cord blood was collected immediately.Serum adiponectin and leptin levels of umbilical blood were measured using the radio immunoassay, while blood lipid levels were examined and neonatal growth parameters were measured. Results (1)There were significant difference of umbilical blood leptin and adiponectin levels among three groups ( P < 0.001), which were higher in LGA group than those in AGA and SAG group(P <0.01). (2)There were positive correlations between the serum leptin levels and body weight, gestational age, head circumference, body length, foot length and placental weight( P < 0.01). There were positive correlations between the umbilical blood levels of adiponectin and birth weight, head circumference, foot length and BMI(P<0.05).(3)Umbilical blood leptin levels were significantly positively correlated with adiponectin (P <0.01). (4) Blood lipid levels were not found significant difference among three groups, there were no significant correlation between umbilical blood adiponectin and leptin levels and blood lipids ( P > 0.05). Conclusion Umbilical blood leptin and adiponectin play an important role in fetal growth and developmental processes.

Objective This study was to investigate the value of CT guided 125iodine implantation combining transcatheter arterial chemoembolization(TACE) to prevent digestive tract bleeding in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods Forty patients with portal vein tumor thrombus which were diagnosed to have primary hepatocellular carcinomas by diagnostic criteria of Chinese Anti-Cancer Association were collected prospectively. They were divided into the treatment group and the control group, with 20 patients in each group. The treatment group was treated by TACE for hepatic tumor and 125iodine seed implantation for portal vein tumor thrombus, while the control group was treated by TACE for hepatic tumor and only given β-blockers medicines after treatment. Intraoperative and postoperative surgery-related complications were observed. Three months after surgery, enhanced abdominal CT scanning was performed to evaluate treatment effects which were divided into complete response (CR), partial response (PR), and progressive disease (PD) and stable of disease (SD), and the local tumor control rates were calculated. The bleeding rates and mortality after 3 months, 6 months, 12 months were recorded. Treatment effects of the two groups were compared with continuously correction Chi-square test, bleeding rates were compared with Fisher test, and survival rates were analyzed with Kaplan-Meier survival curve and compared with Log-rank test. Results Overall the 40 patients were treated successfully without serious surgery-related complications. In the treatment group, there were 8 patients with PR, 6 with SD and 6 with PD, and the local control rates were 40% (8/20). In the control group, there were 1 patient with PR, 6 patients with SD and 13 with PD. The difference of the local control rates was statistically significant (χ2=5.161, P=0.023).The bleeding rates at 3, 6 and 12 months were 2, 2 and 3 cases in the treatment group, for control group they were 2, 6 and 10 cases respectively. There was no statistical difference between the 3 months and 6 months bleeding rates (P values were 1.000 and 0.235), but for 12 months bleeding rates, the difference was statistically significant (P=0.041).The 1 year cumulative survival rates of the treatment group and control group were 70% (14/20) and 40% (8/20), and the difference was statistically significant (χ2=4.675, P=0.031). Conclusion The treatment of 125iodine implantation combining transcatheter arterial chemoembolization in patients with portal vein tumor thrombus in primary hepatocellular carcinoma can reduce variceal bleeding rate and improve survival rate.