Simultaneous Determination of the Contents of 6 Components in Fuzheng Guben Granules by QAMS / 中国药房

OBJECTIVE：To establish the method for content determination of 6 components in Fuzheng guben granules ，such as 2，3，5，4′-tetrahydroxystilbene glucoside ，baicalin，icariin，scutellarin，baicalein and wogonin. METHODS ：HPLC method was adopted. The determination was performed on Dikma Diamonsil C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid aqueous solution （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelengths were set at 275 nm （0-8 min），320 nm（8-9 min）and 275 nm（9-33 min）. The column temperature was set at 25 ℃，and sample size was 10 μL. With baicalin as reference material ，the relative corr ection factors （fk/s） of other five components were calculated by multi-point correction method and slope correction method ；the retention time difference method was used to locate the chromatographic peaks ； the calculation values obtained by above 2 QAMS were compared with measured values of external standard method. RESULTS ： The linear range of 2，3，5，4′-tetrahydroxystilbene glucoside ，baicalin，icariin，scutellarin，baicalein and wogonin were 0.053-2.12， 0.163-6.52，0.059-2.36，0.021 6-0.864，0.03-1.2，0.021-0.84 μg（r＞0.999），respectively. RSDs of precision ，stability（12 h）and reproducibility tests were all lower than 3％. Average recoveries were 98.72％-99.82％（RSDs were 0.89％-1.24％，n＝9）. Using baicalin as reference material ，fk/s of multi-point correction method for 2，3，5，4′-tetrahydroxystilbene glucoside ，icariin，scutellarin， baicalein and wogonin were 1.172，0.528，1.479，1.820 and 2.534，respectively；fk/s of slope correction method were 1.234， 0.550，1.559，1.939，2.664. RSDs of 6 components in 10 batches of Fuzheng guben granules by 3 methods were 0.29％-2.77％ （n＝10），respectively. Pearson correlation coefficient was not lower than 0.999 9（P＜0.001）in measured values between QAMS and external standard method. CONCLUSIONS ：QAMS method is established successfully for simultaneous determination of 6 components in Fuzheng guben granules.

Interferon-related signaling pathways and clinical application in tumor therapy / 国际肿瘤学杂志

Type Ⅰ, Ⅱ, Ⅲ interferons have anti-tumor potential, but the mechanism of action and clinical effect are different. Signaling pathways associated with interferon-treated tumors mainly include JAK-STAT, PI3K/AKT/mTOR, MAPK, NF-κB, c-Abl, etc. Type Ⅰ interferon has the widest clinical application and the most definite curative effect at present. Because of its serious adverse reaction and possible role in the process of cancer induction, type Ⅱ interferon has a great controversy on whether it can be used in anti-tumor therapy. The biological function of type Ⅲ interferon has good characteristics of type Ⅰ and Ⅱ interferon, but its anti-tumor medicinal value needs to be further evaluated.

Effectiveness of double metatarsal osteotomy for severe hallux valgus with increased distal metatarsal articular angle / 中国修复重建外科杂志

Objective: To summarize the technique and effectiveness of double metatarsal osteotomy for treating severe hallux valgus with increased distal metatarsal articular angle (DMAA). Methods: Between June 2014 and December 2017, 64 patients (94 feet) of severe hallux valgus with an increased DMAA were treated with the double metatarsal osteotomy (distal metatarsal Reverdin osteotomy+proximal metatarsal open wedge osteotomy) combined with Akin osteotomy and soft tissue surgery to correct the deformity. There were 10 males (15 feet) and 54 females (79 feet) with an average age of 44.5 years (range, 26-66 years), including 34 of unilateral foot and 30 of bilateral feet. The Maryland metatarsophalangeal joint score of the American Orthopaedic Foot and Ankle Society (AOFAS) was 54.3±7.4 and the visual analogue scale (VAS) score was 6.0±2.0. The pre- and post-operative AOFAS score, VAS score, DMAA, hallux valgus angle (HVA), first-second intermetatarsal angle (1-2IMA), and the first metatarsal length (FML) were recorded and compared. Results: All incisions healed by first intention. All patients were followed up 12-15 months, with an average of 13.2 months. The complications occurred in 4 feet, including 1 foot of hallux stiffness, 1 foot of numbness at the edge of the wound, 1 foot of metastatic metatarsalgia, and 1 foot of metatarsal bone necrosis. At 1 year after operation, the Maryland metatarsal joint score of AOFAS was 89.2±7.4, showing significant difference compared with preoperative score ( t=18.427, P=0.000); and the effectiveness was rated as excellent in 78 feet, good in 12 feet, poor in 3 feet, and bad in 1 foot, with an excellent and good rate of 95.7%. The VAS score was 1.5±2.0, showing significant difference compared with the preoperative score ( t=10.238, P=0.000). The X-ray films showed that the osteotomies achieved bony healing at 3 months after operation. There were significant differences ( P<0.05) in HVA, 1-2IMA, and DMAA between preoperation and 6 months and 1 year after operation; but no significant difference was found in FML between preoperation and 1 year after operation ( t=0.136, P=0.863). Conclusion: For the patients with severe hallux valgus with increased DMAA, the double metatarsal osteotomy can significantly relieve the clinical symptoms and improve the imaging parameters with less postoperative complications.

Clinical Observation of Large-dose of Methylprednisolone Pulse Therapy for Acute Myelitis / 中国药房

OBJECTIVE:To investigate therapy efficacy of large-dose of methylprednisolone plus therapy for acute myelitis, and it effects on nerve function recovery,pyramidal tract conduction function and sensory disturbance. METHODS:A total of 116 patients with acute myelitis were randomly divided into observation group and control group,with 58 cases in each group. Both group received conventional treatment. Control group was additionally given Dexamethasone sodium phosphate injection 0.4 mg/(kg·d)intravenously,once a day;7 d later,they were given Methylprednisolone tablet 60 mg,orally,qd,gradually decreasing to 5 mg/d. Observation group was given Methylprednisolone sodium succinate injection 1000 mg intravenously,once a day;7 d lat-er,they were given Methylprednisolone tablet 60 mg,orally,qd,gradually decreasing to 5 mg/d. The treatment course in eaeh group was 1 month. The nerve function recovery time,pyramidal tract conduction function,sensory disturbance scores,clinical ef-ficacy and ADR were compared between 2 groups. RESULTS:After treatment,the response rate of observation group was signifi-cantly higher than that of control group(93.10% vs. 79.31%);the time of muscle strength improvement≥grade 2,walking down the ground,urination and defecation function recovery in observation group were all significantly shorter than control group,with statistical significance(P0.05). CONCLUSIONS:Based on conventional treatment,large-dose of methylprednisolone plus therapy shows good efficacy in the treatment of acute myelitis,which can helps to improve pyramidal tract conduction function of patients with acute myelitis,ease sensory disturbance,promote the nerve functional recovery with good safety.

Comparison of Therapeutic Efficacy and Safety of 3 Ornidazole Regimens in the Treatment of Chronic Pel-vic Inflammatory Disease / 中国药房

OBJECTIVE:To compare therapeutic efficacy and safety of 3 ornidazole regimens in the treatment of chronic pel-vic inflammatory disease(PID). METHODS:A total of 120 chronic PID patients were randomly divided into ornidazole group(40 cases),combined with levofloxacin group(40 cases)and combined with cefdinir group(40 cases). Based on routine treatment,or-nidazole group was given Ornidazole tablet 0.5 g orally,day and night. Combined with levofloxacin group was additionally given Levofloxacin hydrochloride tablet 0.1 g orally,tid,on the basis of ornidazole group. Combined with cefdinir group was additional-ly given Cefdinir dispersible tablet 0.1 g orally,tid,on the basis of ornidazole group. Treatment course of 3 groups lasted for 10 d. Clinical efficacies of 2 groups were observed,and plasma viscosity (PV),hematocrit,CRP,IL-1,leucocyte count,lympho-cyte count,lymphocyte percentage and the occurrence of ADR were observed before and after treatment. RESULTS:Total response rate was in descending order:combined with cefdinir group(95.00%)>combined with levofloxacin group(82.50%)>ornidazole group(62.50%),with statistical significance(P<0.05). Before treatment,there was no statistical significance in PV,hematocrit, CRP,IL-1,leucocyte count,lymphocyte count or lymphocyte percentage among 3 groups(P>0.05). After treatment,above inel-exes of 3 groups were significantly lower than before;combined with cefdinir group<combined with levofloxacin group<ornida-zole group,there was statistical significance (P<0.05). The incidence of ADR in combined with levofloxacin group was signifi-cantly higher than ornidazole group and combined with cefdinir group,with statistical significance(P<0.05). There was no statis-tical significance between ornidazole group and combined with cefdinir group(P>0.05). CONCLUSIONS:Therapeutic efficacy of ornidazole combined with cefdinir is better than that of ornidazole combined with levofloxacin in the treatment of chronic PID,and its safety is similar to that of ornidazole alone.

Inhibitory Effects of Emodin on the Proliferation of Human Hepatocellular Carcinoma SMMC7721 Cells / 中国药房

OBJECTIVE:To study the inhibitory effects of emodin on the proliferation of human hepatocellular carcinoma SMMC7721 cells. METHODS:SMMC7721 cells were treated with 0(negative control),25,37.5,50,62.5,75,87.5,100μmol/L emodin solution and 100 μmol/L 5-FU for 24 h,48 h,72 h. The optical density value of cells was detected,and inhibition rate was calculated. SMMC7721 cells were treated with 0 (negative control),25,50,75 μmol/L emodin solution and 100 μmol/L 5-FU for 48 h,and cell apoptosis rate,cell cycle and the expression of Bax and Bcl-2 gene were detected. RESULTS:Compared with negative control,the rate of cell proliferation inhibition increased after treated with 25,37.5,50,62.5,75,87.5,100 μmol/L emodin and 100 μmol/L 5-FU,which was positively associated with the concentration and duration. Compared with negative con-trol,the rate of cell apoptosis increased after treated with 25,50,75 μmol/L emodin solution and 100 μmol/L 5-FU;the expres-sion of Bax increased and that of Bcl-2 dereased;50,75 μmol/L emodin solution and 100 μmol/L 5-FU could arrested cells at G0/G1 phase(P<0.05 or P<0.01). CONCLUSIONS:Emodin can inhibit the proliferation of SMMC7721,promote cell apoptosis and in-hibit cell growth.

Is vertebral fixation needed during minimally invasive percutaneous self-dilating pedicle in repair of thoracolumbar vertebral fractures / 中国组织工程研究

BACKGROUND: Most scholars believed that injured vertebral body needs to be fixed in the open surgery of thoracolumbar vertebral fractures; however, it is unclear whether injured vertebra needs to be fixed in the minimaly invasive surgery. OBJECTIVE: To investigate the clinical outcomes of minimaly invasive percutaneous self-dilating pedicle in repair of injured vertebral fixation in thoracolumbar vertebral fractures. METHODS: Totaly 36 patients with thoracolumbar vertebral fractures without nervous system injury who received treatment in Honghui Hospital, Xi’an Jiaotong University Health Science Center from February 2013to February 2014 were enroled and divided into injured vertebral fixation and cross-injured vertebral fixation groups (n=18/group). Patients in these two groups were al subjected to minimaly invasive percutaneous self-dilating pedicle treatment. The injured vertebral body, upper, and lower vertebrae of injured vertebral body were fixed in injured vertebral fixation group, and the upper and lower vertebrae of injured vertebral body was fixed in cross-injured vertebral fixation group. RESULTS AND CONCLUSION: Compared with the injured vertebral fixation group, the cross-injured vertebral fixation group had smaler incisions, less intraoperative blood loss, less operation tine and intraoperative X-ray fluoroscopy time (P 0.05). These results demonstrate that anterior vertebral height cross-injured vertebral fixation has the similar clinical effect with injured vertebral fixation, but cross-injured vertebral fixation had more advantage in the operation. Therefore, there is little significance of conducting injured vertebral fixation in the surgery of minimaly invasive percutaneous self-dilating pedicle in repair of thoracolumbar vertebral fractures.

The effects of DPPI on LPS-induced periodontitis in mice / 实用口腔医学杂志

Objective:To study the effect of dipeptidyl peptidase I(DPPI)on the damage of alveolar bone and inflammatory re-sponse of periodontium in periodontitis mice.Methods:Periodontitis model of left first molars was established in 1 0 DPPI-/-mice and 1 0 wild type(WT)mice by E.coli LPS injection and the right ones were served as the control by PBS injection.Micro-CT scanning and HE staining were performed to compare the damage of alveolar bone and inflammatory response of periodontium between the 2 groups.Results:The decreace of alveolar bone height in DPPI-/-mice was less than that in WT mice〔(Maxillary:(0.001 7 ± 0.000 4)mm vs (0.202 0 ±0.008 6)mm;Mandibular:(0.034 2 ±0.002 9)mm vs (0.332 8 ±0.01 2 5)mm〕(P<0.05).HE staining showed that the inflammatory response of periodontium in DPPI-/-mice was less severe than that in WT mice.Conclusion:DPPI may promote the inflammatory response of periodontis in mice.

Visualization of Multivariate Metabolomic Data / 中草药·英文版

Objective Although principal components analysis profiles greatly facilitate the visualization and interpretation of the multivariate data,the quantitative concepts in both scores plot and loading plot are rather obscure.This article introduced three profiles that assisted the better understanding of metabolomic data.Methods The discriminatory profile,heat map,and statistic profile were developed to visualize the multivariate data obtained from high-throughput GC-TOF-MS analysis.Results The discriminatory profile and heat map obviously showed the discriminatory metabolites between the two groups,while the statistic profile showed the potential markers of statistic significance.Conclusion The three types of profiles greatly facilitate our understanding of the metabolomic data and the identification of the potential markers.

Mating system and causes of low fructification rate by self-pollination of Codonopsis pilosula / 中国中药杂志

<p><b>OBJECTIVE</b>To study four kinds of germplasm resources of Codonopsis pilosula and provide the basal mating systems data for the breeding and cultivation of C. pilosula.</p><p><b>METHOD</b>0.5% TTC (2,3,5-triphenyl tetrazolium chloride) solution was used for the pollen viability test and benzidineand-H2O2 [1% benzidine in 60% ethanol,hydrogen peroxide (3%), and water, 4:11:22] was used for estimation of the stigma receptivity. The mating systems were tested by out crossing index (OC1), pollen-ovule ratio (P/O) and pollination by bagged and emasculated in the field.</p><p><b>RESULT</b>The pollen viability of C. pilosula reached highly about 80% when the pollen staying in the anther, 2-3 days before the petals opening. The anther began scattering pollen before the day of the petals opening, the pollen viability was the highest about 95%, the pollen stick thickly aroud the stigma and quickliy lost in the next day. The stigma life-span was about 4-5 days, the optimal time for pollination was the first day of the petals opening, when the stigma was highly sticky and yellow. The value of out crossing index (OC1) was 4, pollen-ovule ratio was between 104.84-185.75. The natural fructification rate of cross-pollination by emasculated-treatment was 25.6% 42.4%. The fructification rate and compatible index of self-pollination by bagged- treatment were about 3.3%-6.7% and 3.0-21.8.</p><p><b>CONCLUSION</b>The mating system of C. pilosula is mixed with self-pollination and cross-pollination, prone to cross-pollination. The compatibility of self-pollination is high. The difference of maturing period of pistil and stamen and the lack of polen amount cause low fructification rate of self-pollination.</p>

The progress of Chinese medical research on cancer cachexia / 肿瘤研究与临床

Patients with advanced cancer often suffer from cachexia. The researches on cancer cachexis using Chinese medicine include theoretic and clinical studies. The thesis also includes:a systemic comparison to review the progress in recent years, a simple analysis on the problem and shortages of the researches, and a suggestion on the future direction,

Effects of Changrui Enemas on expression of IL-1β and NF-κB in radiation-induced proctitis rats / 肿瘤研究与临床

Objective To observe the effects of Changrui Enemas on IL-1β and NF-κB in the rat model of radiation-induced proctitis, and to explore the mechanism of its repairing mucous membrane and diminishing inflammation. Methods Radiation was given on the pelvis of rats through linear accelerator to establish the model of proctitis. 70 rats were divided into seven groups randomly. Small dose (0.4 g/ml), middle dose(0.8 g/ml) and large dose(1.6 g/ml) of Changrui Enemas by retention enema were given for 7 days, with the admixture liquids of Gentamyein and Dexamethasone, Xilei Powder was used as controls. Changes of IL-1β and NF-κB expression were investigated by semi-quantitative RT-PCR and IHC respectively. Results The expression of IL-1β and NF-κB were determined in the groups accepted radiation, but there had been a dramatic decline in the treatment groups(P<0.05). The high dose treatment group was superior to the low dose one on the whole. Conclusion Changrui Enemas can down-regulate the expression of inflammatory factor IL-1β and NF-κB on radiation induced proctitis rats, and reduce the inflammatory reaction, protect the rectal mucosa, accelerate healing up of the ulcer and relief the symptoms.

Effects of Shengmai Injection on Tumor Growth and the Expression of P-gp in Transplanted Tumor of Human Gastric Carcinoma of SGC7901/VCR Cell in Nude Mice / 医学研究杂志

Objective To explore the effects of Shengmai Injection on tumor growth and the expression of P-gp in transplanted tumor of human gastric carcinoma of SGC7901/VCR cell in nude mice.Methods Transplanted tumor model of human gastric carcinoma of SGC7901/VCR cell in nude mice was built, which was divided randomly into five groups: normal saline control-group, 5-FU group, 5-FU + verapamil group, 5-FU +Shengmai group, Shengmai group. Nude mice growth state was observed, average weigh and inhibition rate of transplanted tumor were calculated, and the expression of P-gp was detected.Results There was significanf difference in terms of transplanted tumor weight,volume among 5-FU+Shengmai group and 5-FU group and normal saline group(P0.05); P-gp express had difference between normal saline group and shengmai group, P

Clinical significance of peritoneal and retroperitoneal edema in patients with decompensated cirrhosis as demonstrated by CT scan / 中华放射学杂志

Objective To investigate the clinical significance of peritoneal and retroperitoneal edema in patients with decompensated cirrhosis(DCC). Methods Forty-four patients were identified with DCC on the basis of clinic and laboratory examinations, except the cases with mesenteric,omental and retroperitoneal edema caused by inflammatory and malignant diseases. The diagnosis of edema depended upon hyperdensity in peritoneal and retroperitoneal. The degree of edema was divided into minor, middle, and sever types based on the extent of edema. Ascites, varices, serum albumin(ALB) levels, and hyaluronicacid(HA) levels were also documented. Correlations between the laboratory and CT findings were analyzed. Results The severity of peritoneal edema was correlated with decreasing serum ALB( r s =0.708 8, P 0.05). Conclusion CT findings of the edema in peritoneal and retroperitoneal may indicate the severity of the liver cirrhosis.

The Effect of Fibrinogen on Intimal Hyperplasia in Organ Culture of Human Saphenous Vein / 中国医科大学学报

Objective:The aim of this study was to identify fibrinogen ( FG ) on the development of intimal hyperplasia ( IH ), using an organ culture model. Methods：Segments(n=9 ) of human saphenous vein ( HSV ) wereharvested during coronary artery or infrainguinal vein bypass surgery. The culture medium supplemented with FG (from0 mg/ml to 5 mg/ml ). The proliferation of smooth muscle cell ( SMC ) quantified by 5′-Bromodeoxyuridine (5′-BrdU) uptake in the final four days of the culture period. Histologic analysis and computerized morphometric analysis were used to determine intimal and medial thickness and area，then the intima/media thickness ratio and intima/media area ratio were calculated. Monoclonal antibodies to 5′-BrdU were used as an immunohistochemical maker for proliferating SMC. Results：Addition of FG ( 2.5 mg/ml ) to the cultured medium caused a significant increase in median ( range ) of intima/media thickness ratio and intima/media area ratio of these segments when compared with the normal cultured vein segments ( Wilcoxon paired rank test )：0.387versus 0.215（P=0.017 ）and 0.396 versus 0.229（P=0.015 ），respectively. Addition of FG ( 5.0 mg/ml ) to the cultured medium also caused a significant increase in median ( range ) of intima/media thickness ratio and intima/media area ratio of these segments when compared with the normal cultured vein segments: 0.421 versus 0.215（P=0.008 ）and 0.382 versus 0.229 （P=0.011 ），respectively. However，there were no significant differences in the two vein segments which 2.5 mg/ml or 5.0 mg/ml FG in cultured medium (P>0.05 ).In addition, there was no significant difference in the median ( range ) of intima/media thickness ratio and intima/media area ratio of the segments which FG ( 0.5 mg/ml ) in cultured medium when compared with the normal cultured vein segments ( P>0.05 ). These were supported by SMC proliferation index using staining with 5′-BrdU. Conclusion：High concentration FG at local preianastimotic area may an important factor for IH and early postoprative vein graft restenosis or occlusion.

Effect of Inhibiting C-myc Gene on Graft Stenosis / 中国医科大学学报

Objective: To investigate the effect of inhibitng C-myc expression by actinomycin D on intimal hy-perplasia in vein graft. Methods: The vein graft model was established in rats. The different dises of actinomycin D (0.015 mg/kg; 0.15 mg/kg) were given just before and after operation. The vein grafts were harvested at 2 hrs and 1 week after grafting. C-myc mRNA was measured by in situ hybridization method. The intimal thickness was measured using a computerised image analysis system. Results: The expression of C-myc mRNA and the intimal thickness were both significantly reduced in large dose (0.15 mg/kg) group of actinomycin D, with 6.5%; 18.7 μm compared with control group in 12.5%; 28.5 μm respectively. Conclusion: Actinomycin D can inhibit expression of C-myc mRNA and intimal hyperplasia in graft. Expression of C-myc plays an important role in inducing proliferation of smooth muscle cell in vein graft.

Mithramycin inhibits intimal hyperplasia of vein grafts after transplantation of the jugular vein to the abdomainal aorta in rats / 中华创伤杂志(英文版)

OBJECTIVE: The intimal hyperplasia caused by mig ration and proliferation of the smooth muscle cells play a most important role in the stenosis of the vein grafts. This study is to explore how the C-myc onc ogene and its protein contribute to the intimal hyperplasia after the jugular ve in is transplanted to the abdominal aorta and to assess the effect of Mithramyci n on the intimal hyperplasia. METHODS: In 60 Wistar rats, a 0.8 cm segment of the right j ugular vein graft was interposed at the level of the abdominal aorta. The experi ment group received Mithramycin (150 mug/kg IP) 1 h before and after the operat ion. The control group received normal saline, specimens of vein graft at 2 and 6 h postoperatively were subjected respectively to in situ hybridization. The ve in grafts 4 weeks after operation were perfusion fixed. The specimens were stain ed with hemotoxylin-eosin and the computer morphologic analysis system was used to evaluate the degree of intimal thickening. Immunohistochemistry studies of m uscle-specific &amg;-actin, C-myc protein and 5'-Bromodeoxyuridine were perfor med. RESULTS: The areas of neointimal and the ratios of neointimal t o medial area were significantly smaller and lower in the Mithramycin-treated t han in the control rats (P<0.05). The 5'-Brdu labeli ng rate between the two groups were also different significantly (P<0.05). Muscl-specific alpha-actin showed that the smooth muscle ce lls formed the most area of myointimal hyperplasia. Steady-state C-myc mRNA le vel was incre ased from 2 h to 6 h postoperatively. The positive rate of the placebo-treated group was higher significantly than that of the Mithramycin-treated group (P<0.05). CONCLUSIONS: Mithramycin may effectively inhibits transcription of C-myc in proliferating vascular smooth muscle cells and could be useful in the prevention of restenosis after vascularization. These results support the hy pothesis that systemic administration of Mithramycin might immediately prevent i ntimal proliferation.

Assessment of CT-Guided Bone Biopsy in Extremities(A Report of 50 Cases) / 实用放射学杂志

Objective In this article we report our methods and effects of CT-guided bone biopsy in extremities.Methods 50 patients with extremital bone lesion were candidates for CT-guided biopsy.Two or more procedures were routinely performed in each case.Ackmann drill was used for 13 patients with sclerotic lesions.Temno core needle was used for 42 cases.Fine needle aspiration was combined for 12 patients with cystic or obviously liquefied lesions.Results In the 50 cases,a diagnosis was possible in 88%(44/50).The six unsatisfactory results were from sclerotic lesions(n=3),liquefied lesions(n=2) and mixed lesion(n=1).50cases were divided into primary malignant tumors(n=23),primary benign tumors and tumor-like lesions(n=12),metastatic tumors(n=8),and bone inflammations (n=7).Their diagnostic accuracies of CT-guided biopsy were 91%,83%,100% and 71% separately.No severe complications were observed in our series.Conclusion CT-guided extremital bone biopsy is a safe,accurate and effective method.Bone drill,needle core and fine needle aspiration should be slected according to the type of bone lesions.In order to increasing its accuracy,the operator should avoid necrotic areas and select more then one point to get samples.One modality can be performed concomitantly with other one in the evaluation of bone lesions,since the three modalities are complementary.