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 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 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.

BACKGROUND:In previous experiments, we have confirmed that platelet rich fibrin has the ability of osteoinduction, and have conducted a preliminary study on its microstructure and biomechanics. However, little is reported on its histology research.
OBJECTIVE:To compare the histological changes after implanting platelet-rich fibrin, Bio-Oss and autologous bone and to analyze the pros and cons of platelet-rich fibrin implantation for repair of bone defects.
METHODS: As previously reported, animal models of critical bone defects were established respectively on the bilateral femoral condyles of 12 beagle dogs. Then, platelet-rich fibrin, Bio-Oss+colagen membrane (Bio-Oss group) and autologous bone (autologous bone group)+colagen membrane were respectively implanted. At 3, 6, 8 and 12 months, one experimental dog from each group was kiled, respectively, and histological observation was performed. Another beagle dog as blank control was enroled to establish the animal model of critical bone defects, with no implantation.
RESULTS AND CONCLUSION:At 3, 6, 8 and 12 months after implantation, there were significant differences in the new bone formation speed and amount between the platelet-rich fibrin group, Bio-Oss group and autologous bone group. These three kinds of bone grafts al had osteoinductive ability to different extents. In the platelet-rich fibrin group, the osteogenic effects were better at 3 and 6 months, and the new bone was similar to natural one; in the autologuos bone group, bone necrosis was noticeable at 3 and 6 months, but the osteogenic effects became better at 8 months, and the new bone was similar to natural one at 12 months; in the Bio-oss group, the osteogenic effects were similar to those in the platelet-rich fibrin group, but the residual of Bio-oss was visible at 12 months; in the blank control group, no bone formed at 3 months, indicating the animal model of critical bone defects was made successfuly. In brief, the platelet-rich fibrin has good osteoinductive ability, with shorter time and better quality.

Aims To study the effects of clenbuterol on anoxia/reoxygenation( A/R) injury in neonatal Wistar rat cardiomyocytes and to explore whether its mecha-nism is related to reperfusion injury salvage kinase ( RISK) or not. Methods The cultured primary neo-natal cardiomyocytes were randomly divided into eight groups: ①normal culture group; ②anoxia/reoxygen-ation( A/R) group;③ clenbuterol ( 1 μmol · L-1 ) +A/R;④ICI118,551(10 μmol·L-1) + clenbuterol ( 1 μmol · L-1 ) + A/R; ⑤Metoprolol ( 10μmol · L-1 ) + clenbuterol(1μmol·L-1 ) + A/R group;⑥Metoprolol ( 10 μmol · L-1 ) + A/R group; ⑦PD98059 ( 20 μmol · L-1 ) + clenbuterol ( 1 μmol · L-1 ) + A/R group;⑧ LY294002(10 μmol·L-1 ) +clenbuterol(1 μmol · L-1 ) + A/R group. Cell via-bility was determined by the conventional MTT reduc-tion assay. The content of LDH in cultured medium was measured with colorimetry. Cardiomyocyte apopto-sis was determined by Hoechst33342 . Intracellular re-active species( ROS) were monitored by the fluorescent DCFH-DA. Total ERK2 and phosphorylated ERK were detected by western blot. Results Compared with A/R group, clenbuterol significantly increased vaibility of cells, reduced LDH release, lowered the rate of apop-tosis and ROS production. When addedβ2 receptor an-tagonist ICI118 , 551 , PI3 K inhibitor LY294002 and ERK inhibitor PD98059 , the effects of clenbuterol a-bove were inhibited; but β1 receptor antagonist Meto-prolol protected the cardiomyocytes from A/R injury, as evidenced by decreased LDH release and increased cell viability. There were no synergistic effects in the combined use of clenbuterol and Metoprolol. Conclu-sion clenbuterol exerts cardioprotective effects against A/R injury by inhibiting oxidative stress and apopto-sis. The protection of clenbuterol is inhibited by ICI118 , 551 , LY294002 and PD98059 . clenbuterol protects cardiomyocytes against A/R injury via RISK pathway by activation of β2 receptor.

Objective To study the intake of iodine and iodine nutritional status of adults and provide a scientific basis for choosing appropriate salt iodine content in the region.Methods By using multi stage random sampling method,according to the four corners of 4 directions,4 non water iodine counties or districts were selected from Nankai District,Jixian County,Dagang District and Hangu District.Totally 1 to 4 administrative villages were selected (neighborhood committees) from each district or county as the survey points.Ten to 15 households were selected from each survey points.All the members more than 18 years old of each household were investigated (excluding pregnant and lactating women).Of the 225 households,404 people,salt iodine of the family,urinary iodine and water iodine were detected.The questionnaire survey was used to investigate the daily salt intake of residents per capita.The daily intake of iodine was calculated by the method of dietary frequency.Salt iodine content was detected by direct titration method;iodine in water was detected by cerium sulfate catalytic spectrophotometry;urinary iodine was detected by arsenic cerium catalytic spectrophotometry.Results A total of 24 drinking water samples were tested,the median water iodine was 8.0 μg/L.A total of 225 salt samples and 404urine samples were tested,the medians of family salt and urinary iodine were 23.30 mg/kg and 149.0 μg/L,respectively.Investigation was done on salt intake and dietary intake of 393 people,the per capita consumption of salt intake was (11.45 ± 5.70) g/d.Salt supplied 148.75 μg/d iodine and food supplied 82.47 μg/d iodine.The total contribution rate of iodized salt to the total iodine intake was 68.99％ (193.18/280.00) in the population of iodized salt consumer.The value of urinary iodine and iodine intake were correlated (r =0.170,P ＜ 0.05).Conclusions The adult iodine nutrition in Tianjin city is in the appropriate level.Iodized salt is the main source of iodine intake for adults,so salt iodine is a indispensable iodine nutrition source for adults.

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.

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.