Objective To investigate the therapeutic effects of arsenic trioxide(ATO) plus vitamin K2(VK2) on proliferation of HL-60 cells from acute promyelocytic leukemia cell line and explore the possible mechanism.Methods ①HL-60 cells were exposed to ATO(0.0,0.5,1.0,2.0,4.0 μmol/L),VK2(0.0,2.5,5.0,10.0,20.0μmol/L),or both of different concentrations (0.5 μmol/L ATO + 2.5 μmol/L VK2,1.0 μmol/L ATO + 5.0μmol/L VK2,2.0 μmol/L ATO + 10.0 μmol/L VK2,4.0 μmol/L ATO + 20.0 μmol/L VK2) for 24,48 or 72 h,respectively.The method of CCK-8 was used to assess the proliferation of HL-60 cells and the half inhibitory concentration(IC50) of ATO or VK2 was calculated,respectively.②Combination index (CI) was used to evaluate the combinative effect of the two treatments:CI ＜ 1,=1 or ＞ 1 indicated synergistic,additive,or antagonistic effect,respectively.③After HL-60 cells were treated with 1.0 μmol/L ATO or 5.0 μmol/L VK2 individually or simultaneously for 48 h,Annnexin V/PI staining was performed to identify the apoptosis rate of each group.Untreated cells were used as control group.Results ①ATO or VK2 alone inhibited the proliferation of HL-60 cells in a concentration and time dependent manner.The IC50 of ATO or VK2 at time of 24,48,72 h were (22.86 ± 2.44),(6.66 ± 0.34),(4.14 ± 0.41) and (18.40 ± 1.12),(13.48 ± 0.73),(8.95 ± 0.40) μmol/L,respectively; ②The combination of ATO and VK2 illustrated a synergistic effect with CI ＜ 1.③No statistical difference was found among control group [(4.38 ± 0.56)％],1.0 μmol/L ATO group [(5.76 ± 1.63)％] and 5.0 μmol/L VK2 group [(6.38 ± 1.42)％] in the apoptosis rate(all P ＞ 0.05).However,the apoptosis rate of combined group did rise to (44.18 ± 8.42)％,with a significant improvement to that of VK2 or ATO group alone (all P ＜ 0.01).Conclusions The combination of VK2 and ATO exhibits an enhanced synergistical inhibitive effect on proliferation of HL-60 cells,and apoptosis may be involved in this synergy in part.

Objective To study the relationships of serum neuroglobin and neuron-specific enolase level with periventricular hemorrhage-intraventricular hemorrhage ( PVH-IVH) and periventricular leucumalacia ( PVL) in preterm infants. Methods There were 241 cases of preterm infants whose gestational age was less than 34 weeks and were admitted in NICU of Guangzhou Women and Children′s Medical Center, Guangzhou Huadu District Matermal and Child Health Hospital and Dongguan Taiping Hospital from Jan. 2010 to May. 2013, enrolled in the study. The serum level of neuroglobin and neuron-specific enolase were detected within 12 hours and on the 3 d, 7 d, 14 d after birth. Cranial ultrasound was preformed 2~3 d, 1week, 2weeks, 3weeks, and 4 weeks after birth. They also received Cranial MRI examination before discharge or when the correct gestational age reached 40 weeks. All 241 cases were divided into 3 groups ( no brain damage group, PVH-IVH group and PVL group) according to the result of cranial US and MRI. The differences of the serum levels of neuroglobin and neuron-specific enolase among each groups were compared. Results The results of cranial ultrasound and /or MRI showed: 162 cases had no brain damage ( in no brain damage group) , 50 cases had PVH-IVH ( in PVH-IVH group) , and 20 cases had PVL, 9 cases had PVL and PVH-IVH ( both in PVL group) . Within 12 h and 3 d after birth, the serum levels of neuroglobin in PVL group and PVH-IVH group was significantly higher than those in no brain damage group (P<0. 05), and the serum levels of neuroglobin in PVL group were signigicantly higher than those in PVH-IVH group ( P <0. 05 ) . On 7 d and 14 d after birth, the serum levels of neuroglobin were no significant difference between PVH-IVH group and no brain damage group ( P>0. 05 ) , and there were still significantly higher than those in no brain damage group and PVH-IVH group (all P<0. 05). The serum levels of neuron-specific enolase within 12 h and 3 d after birth in PVH-IVH group and PVL group were significantly higher than those in no brain damage group ( P<0. 05 ) , and there were no significant difference between PVL group and PVH-IVH group (P>0. 05). On 7 d and 14 d after birth, the serum levels of neuron-specific enolase in PVL group were no significant difference compared with PVH-IVH group and no brain damage group (all P>0. 05). Conclusion The increased serum levels of neuroglobin and neuron-specific enolase in preterm infants within 12 h and 3 d after birth would have certain clinical significance for judging whether early brain damage and PVL would happen.

Objective To investigate the reliability of Narcotrend for monitoring the depth of sedation [the observer's assessment of alterness/sedation(OAA/S) scale] with midazolam and correlation between the depth of sedation and Narcotrend index.Methods 0 ASA Ⅰ-Ⅱ status patients scheduled for elective lower limb operations underwent spinal anesthesia,who were given target-controlled infusion of midazolam.Target plasma concentration was 50ng/ ml at first and increased by 10 ng/ml each grade until OAA/S scale became 1 point.Each target concentration infusion was maintained for 5min.Observe the patient the OAA/S scale to be 5 points.If the operation was not over yet,regulated the appropriate depth of sedation until the end of operation.The Narcotrend index of different OAA/S scale and heart rate,mean arterial pressure,respiration were recorded.Results In the deepening or recovery phase of sedation,OAA/S scales were correlated with Narcotrend index (Spearman' s r =0.786,0.652,all P ＜ 0.05).Conclusion Narcotrend is a good index to guide target controlled infusion of midazolam,the index is closely related with the depth of sedation of midazolam.

imaging features of myositis ossificans have some characteristics. Misdiaguosis could be avoided when the disease was evaluated with the course.

Objective To analyze and explore the value of the mutislice spiral CT (MSCT) scanning,its reconstructive technology and MRI scanning for applying to the identifying diagnosis of new and old vertebral compresion fracture.Methods One hundred and sixty-seven cases with the new and old vertebral compresion fracture who have 189 vertebrae in total were examined using the MSCT scanning,their imaging information were postprocessed with 2D and 3D reconstruction at the work station.Thirty-four patients with overall 43 vertebrae were carried out by MRI scanning and their images were compared with those of MSCT.Results They had the highest proportion of vertebrae in L1 with accounting for 27.68% (31/112) and 35.06% (27/77) among the patients with new and old vertebral compresion fracture,respectively.The next was T12,L2 and T11.There were statistically significant differences between new and old cases in such appearance as fracture line clear and sharp(102 and 21),contusion and hemorrhage of spinal cord(15 and 0),parenchyma shadow beside vertebrae(103 and 11),appendant fracture(26 and 5),organ's lacerated wound around vertebral body(30 and 0),discus intervertebrales vacuum(10 and 36),derangement and hardening of vertebral bone trabecularism(29 and 51) (P＜0.01).Twenty-six vertebrae with the uneven low T1 WI signal,27 vertebrae with the T2 WI fat-suppresion irregular high signal were demonstrated in MRI scanning among 27 vertebrae of 21 cases with new vertebral compresion fracture.While 16 vertebrae with the T1WI and T2WI signals were the same as those of the normal vertebrae,16 vertebrae were the T2WI fat-suppresion low signal among 13 cases with old vertebral compresion fracture.Conclusions The MSCT plays an important role in identifying diagnosis for the most of the patients with the new and old vertebral compresion fracture, while MRI scanning may reflect the pathophysiological characteristics in diagnosis of the spinal cord and the ligament lesion.Therefore,the MSCT and MRI scanning should be integrated to be used to enhance remarkably the accurate rate of the diagnosis.

Objective The purpose of our study is to evaluate high-resolution 3.0 T MRI in the identification of finding in patients with a clinical diagnosis of femoroacetabular impingement (FAI). Methods From June 2008 to May 2010, 54 consecutive patients with clinically diagnostic FAI received an high-resolution 3.0 T MR scan (Siemens AG, Germany), including 38 males and 16 females with an average age of 33.5 years (range, 18-50). All cases were assigned into 3 groups according to the morphology changes of the hip joint: Group Cum, Group Pincer, and Group Normal. The frequency of abnormal signs in 3 groups was calculated. Nonparametric tests by SPSS were used in data analysis. Results Forty-four patients (81.5%, 44/54) showed acetabular labrum disorders, 35 patients (64.8%, 35/54) showed femoral-acetabular cartilage lesions on MRI, 19 patients (35.2%, 19/54) showed arthroedema, 14 patients (25.9%, 14/54) showed femoralacetabular bone disorders, 4 patients (7.4%, 4/54) showed articular capsule and ligaments disorders. There was no statistically significant in the frequency of abnormal sign in MR1 between male and female. The frequency of acetabular labrum disorders, femoral-acetabular cartilage lesions and femoral-acetabular bone lesions in Group Cum was more than that of Group Pincer and Group Normal. The frequency of acetabular labrum disorders was the most disorders (Group Cum 88.5%, Group Pincer 77.8%, Group Normal 70.0%),next high-frequency was acetabular cartilage lesions. Conclusion 3.0 T MRI provides a useful assessment of patients in whom a FAI is clinically diagnosed. A high-resolution, nonarthrographic technique can provide preoperative information. Acetabular labrum disorders and femoral-acetabular cartilage lesions maybe characterized as an earlier period of FAI.

Objective To study of the imaging diagnosis and differential diagnosis of cystitis glandularis. Methods The clinical data and imaging findings of 8 cases with cystitis glandularis proved by pathology were retrospectively analyzed with literaures re-view. Results The lesions on images appeared as nodular mass in 4 cases, diffuse in 2 cases and mixed type in 2 cases,1 case with cystic degeneration. The lesions in 2 cases obviously reduced in size after treatment. The CT value of the lesions post contrast-en-hanced scan averagely increased up to 15.8 HU compared with that of plain scan. The lesions were localized in 6 cases and diffuse in 2 cases. Conclusion cystitis galandularis has some imaging characteristics, but the final diagnosis is depended on pathology.

Objective To explore the variation tendency of serum thyroid hormone level in the elderly aged over 80 years.Methods The 602 healthy volunteers were divided into 3 groups by age:young group (20-59 years of age,n= 226),elderly group (60-79 years of age,n= 195),and advanced age group (80-102 years of age,n=181).Fasting blood of all persons was harvested,then the levels of serum total triiodothyroxine (TT3),total thyroxine (TT4),free tri-iodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH) and reverse tri-iodothyronine (rT3) were determined by chemistry luminescence technique and radioimmunoassay.Statistical analysis was made by the software SPSS 13.0.Results The levels of serum FT3 and TT3 were lower in elderly group than in young group (t=2.793,3.627,P=0.005,0.000).There were significant differences in the levels of serum TT3,TT4,FT3,TSH and rT3 between young group and advanced-age group (t =10.930,6.065,15.398,- 2.933,- 5.643,all P = 0.000),also between elderly group and advanced-age group (t= 8.382,4.298,11.573,-3.383,-5.148,all P＜0.001).The levels of serum FT3,TT3 and TT4 were negatively correlated with age (r=- 0.51,-0.39 and -0.25,respectively,all P＜0.01).And the levels of serum rT3 and TSH showed positive relationships with age (r=0.32,0.12,all P＜0.01).There were no relationships between the level of serum FT4 and age.The positive rate of serum TT3,TT4,FT3,FT4,TSH and rT3 concentration beyond the reference value was 0,0,13.8%,0,6.6% and 21% in advanced-age group,respectively.Conclusions The levels of serum thyroid hormone and thyroid-stimulating hormone change with age.The levels of FT3,rT3 and TSH change obviously in the elderly aged over 80 years.It could reduce the false positive rate in clinical practice if normal reference range for serum thyroid hormone levels in different aged elderly is established.

Objective To evaluate the diagnostic value of CT myelography (CTM) in brachial plexus injury. Methods Twenty-seven patients with brachial plexus injury were examined by using cervical CTM with spiral scan and bone reconstruction algorithm. CT images were reviewed by the senior radiologists, who determined if the nerve root avulsion was presented. The criteria of diagnosing nerve root avulsion were loss of normal nerve root appearance in the Isovist filled thecal sac in consecutive CTM slices plus companion signs. The sensitivity, specificity, and accuracy of CTM in diagnosing nerve root injuries were calculated with operation findings and follow-up results as gold standard. Results Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in consecutive CTM slices. Indirect signs included: (1) Pseudomeningocele bulge: The leak of Isovist into nerve root sheath, and extended into foramina; (2) Arachnoid cyst: displacement of spinal cord; (3) Dissymmetry of subarachnoid cavity: deformity of thecal sac, partially lack of Isovist into arachnoid space; (4) Non-integrity of dural capsule wall: one side of capsule cavity was obstructed. Part of the surface of spinal cord was exposed. Brachial plexus injury could be diagnosed by direct sign with one of the indirect signs. Of the 27 patients (128 nerve roots), 91 nerve root avulsions were found on CTM, and 37 was found normal. Compared with operation findings, 84 were true positive, 7 false positive, 34 true negative, and 3 false negative. Based on these results, the sensitivity, specificity, and accuracy were 96.6%, 82.9%, and 92.2%, respectively. Conclusion CTM is accurate in detecting nerve root avulsion of brachial plexus.

Objective:To introduce the method of cylindrical abdominoperineal resection(APR)for low rectal cancer.Methods:Cylindrical APR was performed for 6 patients with advanced ultralow rectal cancer according to standard protocol in Stockholm from February to May in 2009.The procedure involved careful mobilization of the mesorectum as low as the origins of the levator muscle.After stoma formation,the abdomen was closed,the patient was rotated into the prone position,and an extended perineal dissection was performed.This included the sphinctercomplex and followed the inferior surface of the levators to a point laterally where they originated on the pelvic sidewall.This point should be just inferior to the level where the abdominal procedure was terminated.Results:The cylindrical technique removed more tissue in the distal rectum.There was no bowel perforation,perineal wounds were uneventfully.One patient developed perineal seroma.One patient developed peritoneocele hernia of pelvic floor.Conclusion:Cylin-drical APR performed in the prone position for low rectal cancer removes more tissue around the tumor that leads to a reduction in CRM involvement and intraoperative perforations,which should reduce local disease recurrence.