OBJECTIVETo explore the clinical efficacy and partial mechanism of medicinal-cake-separated moxibustion for senile osteoporosis.

METHODSSixty cases of senile osteoporosis were randomly divided into an observation group and a control group according to the random digits table, 30 cases in each one. The two groups were both treated with basic treatment of western medicine. The acupoints included four groups:① Dazhui (GV 14), Dazhu (BL 11) and Ganshu (BL 18); ② Zhongwan (CV 12), Danzhong (CV 17) and Zusanli (ST 36); ③ Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4); ④ Shenque (CV 8) and Guanyuan (CV 4). Each group of acupoints was selected for one treatment. The observation group was treated with medicinal-cake-separated moxibustion, and the medicinal cake was consisted of fructus psoraleae (30 g), prepared rehmannia root (30 g), atractylodes (30 g), codonopsis pilosula (30 g), epimedium herb (20 g), rhizoma curculiginis (20 g), syzygium aromaticum (5 g) and cinnamon (5 g). The control group was treated with wheat-flour-cake moxibustion. Each acupoint was treated with 5 moxa cones in the two groups. The treatment was given once every other day for six months. The symptom score, lumbar and hip bone mineral density (BMD), serum type Ⅰ procollagen amino-terminal propeptide (PINP) and serum β-type Ⅰ collagen carboxy-terminal peptide (β-CTX) were observed before and after treatment.

RESULTSAfter treatment, the symptom score and serum β-CTX were significantly lowered (all<0.05), while the lumbar and hip BMD and serum PINP were significantly increased (all<0.05) of the two groups. After treatment, the symptom score and serum β-CTX in the observation group were significantly lower than those in the control group (both<0.05), while the lumbar and hip BMD and serum PINP in the observation group were significantly higher than those in the control group (all<0.05).

CONCLUSIONSThe medicinal-cake-separated moxibustion has significant efficacy for senile osteoporosis, which is superior to wheat-cake-se-parated moxibustion.

Objective To evaluate the effects of rigorous surveillance and retroperitoneal lymph node dissection (RPLND) in the treatment of low-risk patients with clinical stage Ⅰ nonseminomatous germ cell testicular tumors (NSGCT) after radical orchiectomy.Methods The data of 71 patients with clinical stage Ⅰ NSGCT were analyzed retrospectively in Hunan Provincial Tumor Hospital,Xiangya Third Hospital of Central South University and Hunan Provincial People's Hospital between Feb,2001 and Apr,2012.Excluding lymphatic and vascular invasion,percentage of embryonal carcinoma＞50％ and increasing tumour markers (AFP/β-HCG) following orchiectomy,46 low-risk patients out of 71 patients with clinical stage Ⅰ NSGCT were selected and divided into rigorous surveillance group (30 cases) and RPLND group (16 cases) according to different therapeutic methods after radical orchiectomy.Univariate analysis was used to confirm variables associated with disease progression,and the disease free survival rates (DFSR) were compared by using Kaplan-Meier analysis.Results Five cases were lost,and 41 cases were followed up for an average of 61 months (range,15-147 months),with 58 months in rigorous surveillance group (range,19-147months) and 65 months in RPLND group (range,15-144 months).The survival rate was 100％ in 2 groups.The DFSR was 89％ (24/27) and 86％ (12/14),respectively,and there was no significant difference between the 2 groups (x2 =0.08,P=0.78).The DFSR was 83％ in patients with small amout of embryonal (percentage of embryonal carcinoma ＜ 50％),and 92％ in patients without embryonal carcinoma,and there was no significant difference between the 2 groups (x2=1.07,P=0.30).Also there was no significant difference between the patients less than 15 years and patients more than 15 years (x2=1.59,P =0.21).Conclusions There is no significant difference in recurrence rate and DFSR between rigorous surveillance group and RPLND group.Low-risk patients with clinical stage Ⅰ NSGCT may achieve satisfactory prognosis with surveillance after radical orchiectomy.

Objective To investigate the expression of survivin/Human leukocyte antigen class I ( HLA-Ⅰ) proteins and its physiological significance in clear cell renal cell carcinoma ( CCRCC ) . Methods Immunohistochemistry was used to analyze survivin/HLA-Ⅰ protein expression in 90 cases of CCRCC and 10 normal tissues to study relationships with clinical symptoms and disease prognosis . Resutl s The level of survivin protein expression was found to be significantly higher in CCRCC tissues 82.2%( 74/90) than in normal tissues( 0/10).However, the relative amount of HLA-Ⅰprotein in colorectal cancer tis-sue was also found to be significantly lower 67.8%(61/90) than in normal tissues 90%(9/10).Survivin expression was associated with tumor grade , stage,and lymph node metastasis ( P=0.000, P=0.016, and P=0.001, respectively ) .Conversely , lost HLA-Ⅰexpression did not have any associations with clinicopath-ological data (P>0.05).Survivin negative patients (25.0%, 4/16) had a higher tumor-free survival rate than patients (52.7%, 39/74)with survivin expression (P=0.037).Patients (27.6%, 8/29) with normal HLA-Ⅰlevels had a higher tumor-free survival rate than those ( 60.7%, 37/61) with reduced HLA-Ⅰlev-els (P=0.020).The univariate and multivariate analyses indicated that expression of survivin and HLA indi -vidually and in combination were independent predictors for CCRCC patient survival . Conclusions Over-expression of survivin but reduced HLA-Ⅰ expression is associated with CCRCC development and progres-sion.

BACKGROUND:The researches about the effect of retinoic acid on the proliferation of adipose-derived stem cells are rare, and the researches on the testosterone are mainly on the inhibition of cellaging. OBJECTIVE: To study the effects of retinoic acid and testosterone or combination on the cellcycle of adipose derived stem cells. METHODS:Adipose derived stem cells were isolated from adult female Sprague Dawley rats with 2 months age and cultured in vitro til passage 3 adipose derived stem cells, and then the 3rd passage adipose-derived stem cells were performed with adipogenic induction, osteogenic induction and surface marker identification. The cells were divided into six groups:(1) Control group;(2) 10-5 mol/L retinoic acid group;(3) Retinoic acid group;(4) 10-5 mol/L retinoic acid+testosterone group;(5) 10-6 mol/L retinoic acid+testosterone group;(6) Testosterone group. The adipose-derived stem cells in the control group were cultured with Dulbecco’s modified Eagle’s medium+10%fetal bovine serum culture medium, and the adipose-derived stem cells in the other five groups were induced with corresponding dose of retinoic acid and testosterone on the basis of control group. After cultured for 36 hours, the flow cytometry was used to detect the changes of cellcycle. RESULTS AND CONCLUSION:Compared with the control group, cellproportions in phase G 1 of 10-5 mol/L retinoic acid group and 10-6 mol/L retinoic acid group were increased significantly, and the cellproportions in phase S were decreased. Compared with control group, the cellproportion in phase G 1 of testosterone group was significantly reduced, and the cellproportion in phase S was increased. Compared with 10-5 mol/L retinoic acid group and 10-6 mol/L retinoic acid group, cellproportions in phase G 1 of 10-5 mol/L retinoic acid+testosterone group and 10-6 mol/L retinoic acid+testosterone group were reduced significantly and the cellproportions in phase S were increased. Retinoic acid can inhibit the cellcycle of adipose-derived stem cells in phase G 1 , and delay the process of the cellcycle from phase G1 to phase S;while testosterone can promote the cellcycle of adipose-derived stem cells from phase G1 to phase S;the combination induction of retinoic acid and testosterone can accelerate the process of the cellcycle of adipose-derived stem cells from phase G 1 to phase S.

OBJECTIVETo investigate whether adipose-derived stem cells (ADSCs) induced by retinoic acid (RA) in vitro express primordial germ cell marker alkaline phosphatase (ALP) and vasa.

METHODSADSCs were isolated from adult female SD rats and cultured in vitro. The third passage of ADSCs was identified by adipogenic differentiation, osteogenic differentiation and cell surface marker detection. The ADSCs were treated with 1×10(-5), 1×10(-6), or 1×10(-7) mol/L RA for 7 or 14 days, and the cellular expression of ALP was detected. vasa mRNA expression in ADSCs treated with 1×10(-5) mol/L RA for 7 days was detected using RT-PCR.

RESULTSThe OD value of ADSCs treated with 1×10(-5), 1×10(-6), or 1×10(-7) mol/L RA was 0.59∓0.04, 0.27∓0.07, and 0.15∓0.03 after a 7-day treatment, and was 0.42∓0.02, 0.34∓0.01, and 0.19∓0.02 after a 14-day treatment, respectively, demonstrating significantly enhanced ALP expression in RA-treated ADSCs compared with that in the control cells (0.07∓0.01 and 0.07∓0.01 at 7 and 14 days, respectively, P<0.01). The ADSCs showed a negative vasa mRNA expression after 1×10(-5) mol/L RA treatment for 7 days.

CONCLUSIONRA-induced ADSCs express ALP, a marker of primordial germ cells, but does not express the primordial germ cell marker vasa.

Adipose Tissue ; cytology ; Adult Stem Cells ; cytology ; enzymology ; Alkaline Phosphatase ; metabolism ; Animals ; Cell Differentiation ; Cells, Cultured ; Female ; Germ Cells ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tretinoin ; pharmacology

Objective To investigate the imaging features of focal nodular hyperplasia and hepatocellular carcinoma on DWI. Methods The data of patients with histopathologically confirmed FNHs and HCCs between August 2008 and November 2010 were collected. A total of 24 patients with 26 FNH lesions and 36 patients with 39 HCC lesions were included in our study. All patients underwent breath-hold DWI with b = 500 s/mm2 and dynamic contrasted-enhanced (DCE) MRI. The imaging findings of FNHs and HCCs were retrospectively analyzed and compared. The signal intensity (SI) of the lesions on DWI were classified as iso-, slightly high, high SI and the distribution of SI between FNHs and HCCs was compared with Fisher exact test. ADC value and lesion-to-liver ADC ratio of FNHs and HCCs were measured and compared by using independent sample t test. ROC was performed to assess the diagnostic value of ADC value and lesion-liver ADC ratio in the characterization FNHs versus HCCs. Results Of 26 FNHs,23 manifested as isointensity or slightly high SI on DWI, but most 25 out of 39 HCCs showed high SI. The distribution of SI between FNHs and HCCs had significant difference ( P = 0. 000). The mean ADC value and lesion-liver ADC ratio for FNHs [ (1.76 ± 0. 62 ) × 10-3 mm2/s and 1.06 ± 0. 18, respectively ] were significantly higher ( P = 0. 001, P = 0. 000, respectively ) than those for HCCs [ ( 1.26 ± 0. 46 ) × 10-3mm2/s and 0. 79 ±0. 12, respectively]. The area (Az) under the ROC for the ADC value and lesionliver ADC ratio for the differentiation of FNHs versus HCCs were 0. 79 ± 0. 05 and 0. 85 ± 0. 05,respectively, with no significant difference (P =0. 270). The specificity of the two measures was 69. 23% and 97.44%, respectively, with significant difference (P = 0. 001 ). Conclusion FNH shows isointensity or slightly high SI with relatively higher ADC value and lesion-liver ADC ratio than those of HCCs on DWI,which is characteristic for its diagnosis and differentiation.

Objective To investigate the diagnostic value of ADC for breast lesions with different enhancement shape or mass size. Methods One hundred and thirty-six breast lesions confirmed by histopathology were included in this study. According to enhancement shape and size of the lesion, all lesions were divided into 3 groups: non-masslike enhancement ( G1 ), masslike enhancement with the largest diameter ＜ 2. 0 cm (G2a) and masslike enhancement with the largest diameter ＞ 2. 0 cm (G2b). Echo planar imaging DWI was performed and three b-values (0,500 and 1000 s/mm2) were applied. The t-test was used for testing the difference of ADC between malignant and non-malignant breast lesions in each group. ROC curve was deduced to test the diagnostic efficiency of ADC. The sensitivity, specificity, negative predictive value( NPV), positive predictive value(PPV) and accuracy of ADC for the diagnosis of breast lesions were calculated under the different threshold. Appropriate b value and threshold were determined with the combination of morphologic evaluation. Results There were no significant differences for the mean ADC values between malignant [b =800 mm2/s: ADC value = ( 1.13 ±0. 23) × 10-3 mm2/s,b=1000 mm2/s: ADC value = (1.05 ±0.20) × 10-3 mm2/s] and non-malignant breast lesions [b =800 mm2/s: ADC value = ( 1.28 ±0. 27) × 10-3 mm2/s, t = 1. 636, P =0. 112,b = 1000 mm2/s: ADC value=(1.20 ±0.23) × 10-3 mm2/s, t = 1.720, P =0. 109] in Group 1. The mean ADC values of malignant breast lesion [b =800 mm2/s: ADC value = (1.07 ±0. 15) × 10-3 mm2/s,b = 1000 mm2/s:ADC value = (0. 99 ±0. 14) × 10-3 mm2/s] were significantly lower than that of non-malignant lesion [b =800 mm2/s: ADC value = ( 1.37 ± 0. 37 ) × 10-3 mm2/s, t = 4. 803, P = 0. 000; b = 1000 mm2/s: ADC value= (1.30 ±0.34) × 10-3 mm2/s, t =4.227, P =0.000] in Group 2a. The mean ADC values of malignant breast lesion [b =800 mm2/s: ADC value = (0. 97 ±0. 14) × 10-3 mm2/s; b = 1000 mm2/s:ADC value = (0. 93 ±0. 14) × 10-3 mm2/s] were significantly lower than that of non-malignant lesion [b =800 mm2/s: ADC value = ( 1.40 ± 0. 39) × 10 -3 mm2/s, t = 4. 227, P = 0. 000; b = 1000 mm2/s: ADC value = ( 1.35 ±0. 36) × 10-3 mm2/s, t =4. 329, P =0. 000] in Group 2b. The diagnostic efficiency was equal( x2 =0. 36,P =0. 5460) whenever b value of 800 or 1000 s/mm2 was selected. The highest sensitivity (97.7%) and NPV (97. 1%) were obtained with b value of 1000 s/mm2 and threshold of 1.25 ×10 -3 s/mm2. Conclusion MR DWI is useful for the differential diagnosis of breast lesions with masslike enhancement rather than nonmasslike enhancement.

Objective To explore and evaluate MRI in diagnosing primary muscle non-Hodgkin lymphoma. Methods Six surgically confirmed primary muscle non-Hod#in lymphoma underwent MR examination including T_1WI, T_2WI and T_1 WI enhanced studies. The acquired images date was reviewed and analysed retrospectively in comparison with surgical and pathological results. Results The locations of 6 cases were cervical part (2), upper extremity (1), lower extremity (3), respectively. All cases involved of more than one anatomical compartment with poorly defined solid masses in 5 cases and well defined in 1 cases, 5 extended to subcutaneous fat and 3 extended along the neurovascular bundle. The mean tumor diameter was 13.9 cm, ranging from 7.3 to 22.5 cm. One was well demarcated and 5 were ill-defined. On T_1 WI, 2 were slighdy high signal intensity and 4 were slighdy low signal intensity. On T_2 WI, 2 were slightly high signal intensity, 3 were intermediate signal intensity and 1 was high signal intensity. Five were inhomogeneous and 1 was homogeneous. The intrinsic structure such as muscle fiber, tendo, spatium intermusculare were detected on 5 cases. Of the 5 dynamic contrast-enhanced cases, it showed moderate enhamcement during arterial phase, 2 were homogeneous and 3 were inhomogeneous. And it showed progressive enhancement during interstitial phase, 3 were homogeneous and 2 were inhomogeneous. Conclusions Primary muscle lymphoma always originated deep to the fascia showing subcutaneous extension and multiple compartment invasion. Typically form poorly defined solid masses with slightly high in signal intensity on MR T_2WI and middle degree dynamic delayed contrasted-enhanced in which intrinsic anatomic structure such as muscle fiber, tendo, spatium intermusculare and so on can be discerned, almost all cases involve more than one muscle compartment and some of tumor extend along the neurovascular bundle.

Objective To Explore the imaging features relative to pathology of pelvic chondrosarcoma and to evaluate the clinical value.Methods All 12 cases patients with primary pelvic chondrosarcoma confirmed by pathological examination underwent radiography,spiral CT plain scanning,MR SE-T1WI,FSE-T2WI and SE-Tl WI enhancement scanning before operation.The imaging data was reviewed and analyzed retrospectively to compare with surgical and pathological results.Results Eleven conventional chondrosarcoma and one dedifierentiated chondrosarcoma were located in different parts of pelvis.The diameters of the tumors ranged from 4.7 to 17.0 cm with one case less than 5.0 cm,6 cases being 5.O-10.0 am and 5 cases more than 10.0 Cln.The CT valHe of 5 cases was identical or inferior to muscle with mild to moderate"ring-and-arc"mineralization and soft mass.MR imaging depict the high water content of these lesions as very high signal intensity was detected on T2 WI.Six cases showed typical"ring-and-arc"fibrous tissue which enhanced persistently.Aggressive features of deep endosteal scalloping and soft-tissue extension was also found in these cases.Conclusions Radiographic findings Can suggest the diagnosis of pelvic chondrosarcoma when there is typical"ring-and.arc"fibrous tissue,mineralization,aggressive features of deep endosteal scalloping and large soft-tissue extension.MR imaging reflect directly this pathologic structure,superior to that of CT and radiography.CT is optimal to detect the matrix mineralization,particularly when it is subtle or when the lesion is located in anatomically complex pelvic areas.

Objective To explore the imaging features of primary malignant fibrous histiocytoma(MFH)of bone and correlate them with pathological findings.Methods Thirteen cases patients with primary MFH of bone confirmed by surgical pathology underwent radiography,spiral CT plain scanning and MR SE-T1 WI,T2 WI and SE-T1 WI enhancement scanning before operation.The imaging date was reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Of 13 MFH,11 were located in the end of long bone,and 2 in the diaphysis.The distance between tumors in the end of long bone and adjacent joint surface was 1 to 5 cm.All lesions showed osteolytic destruction with the maximum diameter of the tumors from 5.3 to 12.7 cm.The tumors had eccentric aggressive osteolytic destruction in 10 lesions,internal crest within the lesions in 7,inconsecutive marginal osteosclerosis in 11,little periosteal reaction in 2 and small soft tissue masses in 9,respectively.The CT value of lesions was similar to muscle.MR imaging depicted low signal intensity with aggressive features on T1 WI,iso to slight high signal intensity on T2 WI,and middle or high degree contrast enhancement on enhanced T1 WI images.Macroscopically,MFH was usually located eccentrically within the bone and produced little or no osseous expansion.The soft tissue component appeared multi-nodules and pseudo-encapsulated.Histologically,they consisted of spindle-shaped fibroblasts,which radiated outward in a spiral array from a central focus and produced a nebula or storiform appearance,and cells,which were small and oval with little visible cytoplasm.Conclusions The imaging manifestations of MFH were specific to some extent.Combined utilization of plain X-ray,CT,and MRI is helpful for the diagnosis and differential diagnosis of MFH.