[Objective]To investigate imaginological evidences of hyperxtensive injury of cervical spine and to evaluate its use in clinics.[Method]Seventy-eight patients with hyperextension injury at cervical spine by different cause were estimated by radiograph、CT and MRI.Fifty-seven cases(73.1%) appeared with widen of soft tissue of anteriorspine,including focal type(17.5%) and diffused type(82.5%). Thirty-six cases showed avulsion fracture of anterior edge in the cervical spine. Sixty-three cases showed degeneration and developmental spinal stenosis,twenty-one cases appeared integral vertebral canal. No contrast CT scan showed osteophyte of thirty-seven cases and intervertebral discs degeneration and protrusion of twenty-one cases.Sixty-one cases(78.2%) with both disc and anterior-longitudinal-ligament injury showed by MRI,fifty-seven cases showed haematoma and oedema at the anterior of the vertebral body. Sixty-four cases accompanied with different spinal cord injury.[Result]Obvious imaging feature for hyperextension injury of cervical spine,including anterior longitudinal ligament,intervertebral disc and spinal cord were found.There exists good relationship between spinal cord injury and imaging appearance. Clinically it showed typical central syndrome,but mostly showed us neuron-functional disturbance of different degree.[Conclusion]Combining of imaginological apperarance including radiograph,CT,MRI can provide evidences for diagnosis of hyperextension and help to treat acute hyperextension cervical injury.

Objective To explore the glycerin suppositories nonretention enema treatment and the clinical ef- ficacy on acute constipation induced by a variety of unknown reasons. Methods 164 patients were randomly divided into two groups: observed group (81 cases) and the control group (83 cases ). Observed group used enema by 80ml glycerin suppositories retention. Control group used excessive traditional liquid soap retention enema. Effects of differ- ent methods of enema were compared according to fecal condition 5～20min after operation. Results The glycerin suppositories retention enema was much better than soap water retention enema with the total effective rate of 97.5 % and 81% respectively. The glycerin suppositories retention enema solution to the overflow and the occurrence of adverse reactions were significantly lower than those of the control group. There were significantly statistical dif- ferences(P < 0. 01). Conclusion Using the glycerin suppositories retention enema for the constipation, has no side effects,skin and beds contamination and patients are more willing to accept it.

Objective To evaluate the clinical application value of the PPH in the treatment of severe prolapsed hemorrhoids.Method Forty cases with severe prolapsed hemorrhoids underwent improved PPH with homemade stapler.Results The operating period of time was 10～20min and the mean hospitalization period of time was 4 days.All the 40 cases were cured,of whom bleeding in 2 cases,postoperative malaise at the lower abdomen in lO cases,urinary retention in 11 cases,slight pain in 20 cases.After following-up for 3～15 months,there were no such complication as prolapse again,and no anal stricture,fecal incontinence,etc happened.Conclusion The improved PPH is a safe and effective new method in the treatment of severe prolapsed hemorrhoids.

Objective To evaluate the earlier changes of degeneration discs in vivo using magnetic resonance diffusion tensor imaging (DTI).Methods From September 2010 to March 2011,88 consecutive outpatients [age 16-63 years,mean age (37 ± 13) years] were enrolled in this study.The excluded criteria were as follows: spinal deformity,spinal tumors and post-operation of spine.The mean diffusion (MD) and fractional anisotropy (FA) values on DTI images of 428 intervertebral discs which without susceptibility artifacts were measured.Fiber track (FT) images of annulus of intervertebral discs were analyzed.MD and FA were also measured on FT.The quartile and median were used to record the nonnormal distribution dates.The Chi-square test statistic was applied by SPSS1 1.0 software package.Results Annulus fibrosis type had closely related to the Pfirrmann grading.Three types were divided based on FT charts of degenerated intervertebral disc.Intact type was noted in 135 discs,Pfirrmann Ⅱ level has a high percentage(92 discs,68.15％) in this type; Scrambled type was noted in 195 discs,Pfirrmann Ⅲ and Ⅳ level were accounted for 63.07％ (123 discs) ; Conglomerate type was noted in 98 discs,the Pfirrmann Ⅳ and Ⅴ level were accounted for 83.68％ (82 discs) (Mantel-Haenszel test,x2 =183.90,P ＜ 0.01).Different annulus types had different MD and FA values.The median(range)of FA of complete,messy and clumps type fibrous ring were 0.32 (0.29-4.35),0.35 (0.33-0.38),0.54 (0.46-0.62).The corresponding median(range)of MD were 12.40(11.50-13.20) x 10-10,11.10(9.92-12.00) × 10-10,6.30(5.03-7.72) × 10-10 mm2/s.Scrambled annulus fibers had lower MD values and higher FA values,which had significant difference (x2 =219.74,243.88,P ＜0.01).Conclusions DTI is a non-invasive method to assess intervertebral disc structural changes in vivo.MD and FA values are helpful to evaluate the intervertebral disc degeneration.

Objective:To evaluate the relationship betweenparacardial adipose tissue (PAT) volume, body mass index (BMI) and severe coronary artery stenosis in young people by quantitative measurement of 256-slice spiral CT.
Methods: A total of 150 patients younger than 45 years and received coronary angiography (CAG) in our hospital were divided into 2 groups:Lesion group, the patients with severe main coronary branch stenosis and Control group, patients with normal coronary artery. n=75 in each group. The height, body weight and BMI were recorded in all patients;imaging data was uploaded to the workstation to calculate the volumes ofepicardiumadipose tissue (EAT) volume,pericardial outsideadipose tissue volume and PAT volume, the correlation among 3 parameters were analyzed respectively.
Results:Compared with Control group, Lesion group had increased BMI (28.169±2.203) kg/m2 vs (24.960±3.041) kg/m2 and PAT volume (178.676±3.041) ml vs (99.0616±3.041) ml, all P<0.05. Compared with Control group,no matter male or female, Lesion group had larger PAT volume, P<0.01.EAT volume was related to pericardial outside adipose tissue volume (r=0.837, P<0.001) and PAT volume (r=0.971, P<0.001);pericardial outside adipose tissue volume was related to PAT volume (r=0.944, P<0.001).
Conclusion:PAT volume and BMI were obviously correlated to severe coronary artery stenosis in young people.

Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rifampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis,and compare with debridement alone.Methods From May 2005 to August 2010,48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province.Among them,27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection (Grafting group),and 21 case were treated with radical debridement only(Control group).The local wound healing,adverse reactions and regular imaging examination (pelvic X-ray and CT scan) were observed,and the surgical time,the intraoperative blood loss,postoperative 6 months and 12 months,18 months bone graft fusion rate,and Majeed scoring results of the patients were recorded and statistically analyzed.Results All patients were followed up from 20 to 30 months with an average of 24 months.There was no significant difference in terms of surgical time and operative bleeding between the two groups(P＞0.05).The rate of bone fusion in grafting group was 33.33％ (9/27) of 6 months after operation,88.9％(24/27) of 12 months after operation,and 96.3％ (26/27) of 18 months after operation.While that in control group was 4.76％ (1/21) of 6 months after operation,42.85 ％ (9/21) of 12 months after operation,and 42.85％ (9/21) of 18 months after operation.The differences of these parameters between the two groups were significant(x2 =5.85,20.92,15.90;P＜0.05).According to Majeed scoring system,the excellent and good rates were 100％ (27/27) in grafting group,76.19％ (16/21) in control group,the difference was statistically significant(x2=7.18 P＜0.05).Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sacroiliac joint tuberculosis,and reduce the adverse reactions,achieve bone fusion earlier than the control group.

Hemodynamics is a discipline that studies the effects of blood flow,blood flow volume and other factors on the arterial wall.Intracranial aneurysm is the main cause of death due to non-traumatic subarachnoid hemonhage,which has brought a heavy burden on society.Therefore,it is very important to make an intensive study of the pathogenesis of aneurysm.With the development of medical imaging technology and fluid mechanics software in recent years,it becomes possible to make the precise and scientific studies of the hemodynamics of intracranial aneurysms.In this paper,the hemodynamic factors inducing the formation of intracranial aneurysm that are proposed by medical experts at home and abroad are reviewed,and the hemodynamic mechanism is discussed.

Objective To discuss thk curk kffkct and sidk kffkcts of donor anti-CD19 chimkric antigkn rkckp-tor T lemphocetks(CD19 CLA-T)for trkating rkcurrknt acutk B-ckll lkuckmia aftkr allogknkic hkmatopoiktic stkm-ckll transplantation(Lllo-HSCT),and to analezk thk influkncing factors for this thkrape. Methods Thk clinical data of 5 acutk B-ckll lkuckmia patiknts wkrk analezkd rktrospkctivkle who rklapskd aftkr Lllo-HSCT and rkckivkd donor CD19 CLA-T thkrape at Bkijing Childrkn＇s Hospital from Jule 2015 to Octobkr 2017. Diskask status bkfork infusion, conditioning rkgimkn,rkinfusion ckll dosk,and sidk-kffkct of CLA-T infusion,changks in thk rklatkd immunological indicators,and follow-up trkatmknt rksults wkrk invkstigatkd. ResuIts Onk patiknt had no kffkct,othkr patiknts got rk-mission or minimal rksidual diskask(MAD)nkgativk within 4 wkkcs aftkr CLA-T infusion,and thk middlk timk was 14 daes. Pkriphkral CLA-T pkac happknkd 2 wkkcs aftkr CLA-T infusion. Be thk last follow,2 patiknts dikd of lkuckmia, 3 patiknts wkrk alivk,and 1 cask of thkm livkd with tumor aftkr CD19 nkgativk rklapsk,othkrs livkd with diskask-frkk condition. Cetocink rklkask sendromk(CAS)was thk most common sidk kffkct,happkning in 1 to 2 wkkcs aftkr infusion, 1 patiknt had nkurologic toxicitiks,and 2 patiknts had suspicious graft -vkrsus -host diskask. ConcIusions Donor CD19 CLA-T thkrape has a good short-tkrm kffkct for rklapskd B -ckll lkuckmia patiknts aftkr Lllo -HSCT,but long-tkrm kffkct rkquirks furthkr obskrvation;CAS is thk most common sidk-kffkct. Off-targkt and ckll kxhaustion ark thk main rkasons for dkfkat.

Objective: To investigate the clinical features and prognosis of rare subtypes of renal cell carcinoma. Methods: This retrospective study collected the data of 52 rare subtypes of renal cell carcinoma of patients who underwent surgery from January 2002 to December 2014 at Department of Urology, Peking University First Hospital. There were 12 patients with collecting duct carcinoma, 5 patients with Xp11.2 translocation renal cell carcinoma, 5 patients with mucinous tubular and spindle cell carcinoma, 30 patients with unclassified renal cell carcinoma. The study group included 25 male and 27 female patients, with mean age of 52 years. The mean tumour size was (6.5±3.9) cm (range: 1.5 to 21.0 cm). The basic clinical features, gross appearance, Fuhrman nuclear grade, TNM staging and prognosis of rare subtypes of RCC were studied. The OS curves were obtained for rare subtypes of renal cell carcinoma using the Kaplan-Meier method and compared using a Log-rank test. Results: The rate of lymph node and distant metastasis were 34.6% (18/52) and 17.3% (9/52). Malignancies were screened and detected by color Doppler ultrasonography or CT scan, however, no case was diagnosed before operation or aspiration, all cases were confirmed by the pathological examination. The average period of postoperative follow-up process was 65 months, and the mean survival time was (34±23) months. Conclusion The clinical features of rare subtypes of renal cell carcinoma are similar to those of clear cell renal cell carcinoma, while the imaging changes will be helpful for diagnosis before operation.

Objective: To study the clinical characteristics, image findings, therapeutic method and prognosis of metanephric adenoma. Method: The clinical characteristic, image findings, operation methods and prognosis of 16 metanephric adenoma patients treated at Department of Urology, Peking University First Hospital from January 2004 to March 2016 were analyzed retrospectively. Results: There were 6 male and 10 female patients in the study. The mean age of patients was 33.7 years (ranging from 14 to 83 years). Two patients came to the hospital because of fever, while other 14 patients had no symptoms and found renal tumor by medical examination. One case was found polythemia vera and another 1 case showed mild anemia. Serum creatine of all the cases were in normal range. The tumor of 11 cases were at left side and 5 cases were at right. All patients took urinary tract ultrasound. Fifteen patients took CT examination. Among them, 14 cases were solid mass and 1 case was cystosolid.CT value was (41±4) HU. CT scan showed that the tumor was slight enhanced and CT value increased to (77±9) HU. Six patients took MRI examination. The MRI showed high or low signal of T1WI or T2WI scans.Tumor size was (4.7±3.9)cm (ranging from 1.7 to 17.5 cm). All 16 patients took operation and 11 of them took laparoscopic surgery while the other 5 cases took open surgery. Eleven cases took partial nephrectomy, 4 cases took nephrectomy and 1 case took nephroureterectomy. The surgical procedures were all successful and no complications occured during perioperative period. All cases were all confirmed metanephric adenoma by postoperative pathology and surgery cut edge were all negative. Immunohistochemical study showed that the positive rate of Vimentin, CD57, AE1/AE3, WT1, CK7 and AMACR respectively were 16/16, 15/16, 12/16, 10/16, 3/16 and 2/16. The median follow-up time of 16 cases was 44 months (ranging from 8 to 125 months) and none had recurrence or metastasis.One case died 125 months after surgery because of advanced age(83 years old). Conclusions Metanephric adenoma is difficult to be diagnosed relying on clinical characteristics and image features. Pathology can help confirm the diagnosis. Partial nephrectomy is the first choice for operation and can achieve good prognosis. But it still needs a regular follow-up.