Objective To study the clinical and pathological features of primary nephrotic syndrome in elderly patients.Methods Clinical data of patients with primary nephrotic syndrome aged ≥ 60 years underwent renal biopsy were retrospectively analyzed and patients with primary nephrotic syndrome aged ＜60 years were selected as control group.Results Male patients with primary nephrotic syndrome were common in the elderly group and control group,and there was no significant difference in gender composition between the two groups (62.0％ vs.61.5 ％,P＞0.05).The degree of edema and hypertension,levels of blood urea nitrogen,serum albumin,blood IgG and ratio of IgG /IgM were higher while levels of urinary protein and blood cholesterol were lower in elderly group than in control group (all P ＜ 0.05).No significant differences in the incidence of hematuria,serum levels of creatinine,IgA,and complement were found between the two groups (all P＞0.05).The risk of primary nephrotic syndrome was higher in elderly group than in control group (P＜0.01).The level change of blood IgG was positively associated with plasma albumin,while negatively associated with urinary protein and blood cholesterol in both groups (r=0.327,-0.147,-2.860,respectively,all P＜0.05).Membranous nephropathy was the most common type in elderly patients,accounting for 49.77％,while only accounting for 23.6％ in control group,which had a significant difference between the 2 groups (x2 =62.390,P ＜ 0.01).Mesangial proliferative glomerulonephritis was common in both groups,but no significant difference(x2 =62.390,P＞0.05).Conclusions Male patients are more common than female patients in primary nephrotic syndrome.The clinical manifestations including urinary protein and serum albumin are milder but the risk is much greater in elderly patients than in the non-elderly patients.The change of blood IgG level is associated with urine albumin,plasma albumin and plasma cholesterol.Membranous nephropathy is the most common type followed by mesangial proliferative glomerulonephritis in elderly patients with nephrotic syndrome.

Objective To study the risk factor and prognosis of concurrent depression in elderly patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI). Methods Two hundred and ninety-five AMI patients who received PCI and whose clinical data were complete were selected. Depression was determined by a self-rating scale (SDS), and was confirmed when SDS standard score≥53 scores. The patients were divided into 2 groups according to the ages:senium (age ≥ 60 years, 144 cases) group and younger group (age<60 years, 151 cases). Multiple Logistic regression analysis was used to analyze the related factors of depression. The patients were followed up for 1 year, and the rehospitalization rate, incidence of major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) at 12 months were compared. Results The incidence of depression in senium group was significantly higher than that in younger group: 41.7%(60/144) vs. 21.2%(32/151), and there was statistical difference (P<0.05). Female gender, hypertension and type 2 diabetes mellitus were the independent risk factor for depression in patients with AMI after PCI (P<0.05). In senium group, the rehospitalization rate and incidence of MACE in patients with depression were significantly higher than those in patients without depression: 18.3% (11/60) vs. 6.0% (5/84) and 15.0% (9/60) vs. 4.8%(4/84), the LVEF was significantly lower than that in patients without depression:(41.50 ± 2.25)%vs. (49.76 ± 2.93)%, and there were statistical differences (P<0.05). The LVEF in patients with depression of senium group was significantly lower than that in patients with depression of younger group:(41.50 ± 2.25)%vs. (51.50 ± 2.32)%, and there was statistical difference (P<0.05). Conclusions The elderly AMI patients treated with PCI have higher rates of depression. Female gender, hypertension and type 2 diabetes mellitus are the important risk factor for depression after PCI. Depression has a significant effect on the prognosis of AMI patients, especially on LVEF in elderly patients.

The effects of gradual tibia lengthening at different speeds on the histomorphology of tibial nerve were studied in 30 rabbits by self-made external distraction device. It was showed that the leg was tracted at the speed of 1 mm/d, the tibial nerve was lengthened correspondingly. Gradual stress could stimulate the growth of nervous tissue and no nervous functional and constructural injuries were found When the leg was distracted at the speed of 2 mm/d, limb elongation within 40% was safe, otherwise, severe nervous damage would occur.

Objective To assess the anatomic morphology of the connective structures among brain ventricles and cerebrospinal fluid (CSF) movement in them by CSF spin-labeling MR imaging. Methods According to the order of registration, 50 healthy volunteers were randomly selected and received cerebrospinal fluid spin-labeling MR scan with time-spatial labeling inversion recovery single-shot fast spin echo sequence (SLIR-SSFSE). The tagged CSF was used as an endogenous tracer. The anatomic morphology of the connective structures of brain ventricles and the flow direction of CSF were observed. The longitudinal diameter and transverse diameter of bilateral foramina of monro, midbrain aqueduct, and the central and bilateral lateral apertures of the fourth ventricle of each subject were measured and calculated based on multiple measurements. The flow rate of CSF was calculated based on the flow distance of CSF in the connective structures between brain ventricles during different TI time. The mean value of each indicator was acquired. Results Two-way flow state of CSF was observed in all connective structures, including bilateral foramina of monro, midbrain aqueduct, and the central and bilateral lateral apertures of the fourth ventricle. On the coronal planes, foramen of monro appears as a "Y"-type tubular structure locating among the both sides of the anteriomedial thalamus and fornix, which connect upward with bilateral lateral ventricles and downward with the third ventricle. The longitudinal diameter and transverse diameter of the left side of foramen of monro were 3.50-5.50 mm[mean (4.37 ±0.47)mm]and 1.00-1.40 mm[mean(1.21 ±0. 13) mm], respectively. The longitudinal diameter and transverse diameter of the right side of foramen of monro were 4. 20-4. 80 mm[mean(4.42 ± 0.20) mm]and 1.00-1.60 mm[mean (1.21 ±0. 19) mm], respectively. On the sagittal planes, foramen of monro appeared as an oblique fine tubular structure with the angle of 55°-58° between the both sides. CSF flow velocity towards the foot was 1.61-2. 52 mm/s[mean (2. 00 ± 0. 17) mm/s]in the left side of foramen of monro and 1.93-2. 20 mm/s [mean (2.03 ±0.09) mm/s]in the right side of foramen of monro. On the sagittal planes, midbrain aqueduct appeared as a curved tubular structure through diencephalon, with the longitudinal diameter of 9.90-17.30 mm[mean(15.51 ± 1.70) mm]and the transverse diameter of 1.70-2.30 mm[mean (1.92 ± 0. 17)mm]. In midbrain aqueduct, CSF flow velocity towards the foot was about 5.00-8.74 mm/s[mean (7.84 ±0.86) mm/s]and towards the head was about 3.84-6.71 mm/s[mean (6. 01 ±0. 66) mm/s]. On the sagittal plane, the central apertures of the fourth ventricle appeared as a fork-like tubular structure, with a small bifurcation forward to the central canal of the medulla oblongata and a posterior branch downward to cerebellomedullary cistern. On the coronal plane, lateral apertures of the fourth ventricle appeaed as curved tubular structures connecting the lateral horn of the fourth ventricle and cerebellomedullary cistern. The longitudinal diameter and transverse diameter of the left lateral aperture were 6.30-14. 60 mm[mean (10.42 ±2.88) mm]and 1.00-1.50 mm[mean (1.24 ±0.18) mm],respectively; of the right lateral aperture, they were 6. 20-15.50 mm[mean (12. 13 ± 3.05) mm]and 1.00-1.40 mm[mean(1.19 ±0. 13) mm], respectively. The angle range between the left and right lateral aperture was from 87° to 114°. CSF flow velocity towards the foot was about 2. 89-6. 70 mm/s[mean (4. 78 ± 1.32) mm/s]in the left lateral aperture and 2. 84-7.11 mm/s[mean (5.56 ±1.40) mm/s]in the right lateral aperture. Conclusions CSF spin-labeling MR imaging could display the anatomic morphology of the connective structure among brain ventricles and could be used for noninvasively assessing CSF movement.

Objective To study diffusion characteristic, diffusion-weighted imaging (DWI) technique and its value in lumbar osteolytic metastases. Methods Twenty patients with lumbar osteolytic metastases and 20 controls were performed with sagittal SE T_1WI, FSE T_2WI, fat saturation FSE T_2WI(FS-FSE T_2WI)and single-shot spin-echo echoplanar DWI, respectively. Contrast noise ratios (CNRs) of the metastases on various series were compared. On DWI, signal attenuation ratios (SARs) and apparent diffusion coefficients (ADCs) of lumbar osteolytic metastases and normal vertebrae were analyzed. Results (1) Routine MRI appearance: There were 23 lesions in the 20 patients. The signal intensity of all lesions showed hypointense on SE T_1WI, hyperintense on FS-FSE T_2WI and DWI, and mixed signal intensity (5 cases), isointense (12 cases) or slight hyperintense (6 cases) on FSE T_2WI. (2) CNR: The CNRs of patient group on FSE T_2WI(5.70?3.82)were lower than those on SE T_1WI(25.62?11.73), FS-FSE T_2WI(23.37?7.48)and DWI (b=600 s/mm2)(24.69?9.87)(U values were 5.393, 6.359, and 5.547, respectively,P

Objective The purpose of the study was to characterize the X-ray and CT findings of ameloblastomas of the jaw.Meth-ods X-ray (n=9)and CT (n=20)findings of 20 patients with pathologically proven ameloblastomas of the jaw were obtained.Image features included location,size,shape,density of the lesion,and changes of adjacent bone were assessed.Results 1 9 cases were located in the mandible,including 10 cases in the molar-ramus region,four cases in the whole half of the mandible body,two cases in the whole half of the mandible body and the opposide mantum,one case in the whole mandible body,two cases in the anterior teeth region and mantum.One case was located in the molar region of the maxilla.Three cases were uniocular and 17 cases were multiocular in shape.All lesions caused expansile changes in the adjacent bone,including expanding towards the lip and bucca(n=15),the lingua(n=3),and expanding uniformly(n=2).The interruptions of the surrounding bone cortex were demonstrated in 1 9 cases.Conclusion There are some characteristic imaging find-ings for ameloblastomas of the jaw.Correct preoperation dignosis can be made on the basis of imaging findings.

Objective To explore the imaging differences of vertebral multiple myeloma(VMM)and vertebral osteolytic metastasis on CT. Methods Review the imaging signs of 32 patients with VMM and 52 patients with vertebral osteolytic metastasis,then record and finally statistical analysis was carried out.Results Compare to 1 67 vertebras involved in 52 cases of vertebral metastasis,the patents with VMM had 220 vertebras involved.The incidence of the multiple small circular type of bone destruction in VMM was 42.66%(93/218),which was higher than that in vertebral metastasis 0.00% (0/165)(χ2 =92.963,P =0.000).The incidence of the irregular shape type of bone destruction in VMM was 23.39% (5 1/218),while it was higher in patients with vertebral metastasis 45.45%(75/165)(χ2 =20.704,P=0.000).It was also found that the incidence of the fragmentary type of bone destruction and the involvement of the unilateral pedicle in VMM were lower than that in patients with vertebral metastasis 8.7% (19/218 )& 27.27% (45/165)(χ2 =23.238,P =0.000), 6.82% (1 5/220)& 1 7.96% (30/1 67)(χ2 =1 1.477,P =0.001).The incidence of the crest protrusion type of bone destruction in patients with VMM was 16.06% (35/218),however it was 9.10% (15/165)(χ2 =4.013,P =0.045)in vertebral osteolytic metastasis. Conclusion The imaging features of VMM and vertebral osteolytic metastasis had certain characteristic.And they can be differentiated from each other,combining with clinical traits.

Objective To observe the clinical response and safety of second-generation tyrosine kinase inhibitor dasatinib in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). Methods The clinical data of 10 adult Ph + ALL patients treated with dasatinib were analyzed with review of literatures. Results All the 10 Ph+ ALL patients treated with dasatinib achieved remission in 7 weeks, including 9 cases of complete remission [7 cases achieved complete molecular remission (CRm) in 13 weeks]. The median overall survival time (OS) was 13.8 months (5-33), and the median disease-free survival (DFS) time was 10.8 months (4-25). There were 3 cases of pleural effusion, 4 cases of Ⅳ degree of bone marrow suppression and 6 cases of extremely low blood platelet, which could be that was improved via by symptomatic treatment and, with no case of the death occurred during the treatment of dasatinib, the safety was high. Conclusion Dasatinib can deepen molecular biological reaction and prolonged the survival time of patients in the treatment of adult Ph+ ALL, with high remission rate and safety, and which can be considered as first-line treatment.

Objective To observe imaging characteristics of carotid body tumor and schwannoma in carotid space. Methods CT, MRI and digital subtraction angiography (DSA) appearances of 16 patients with carotid body tumors and schwannomas in carotid space confirmed pathologically were retrospectively analyzed. There were 8 patients with carotid body tumors and 8 patients with schwannomas. Six patients with carotid body tumors and 5 patients with schwannomas underwent CT plain scan. All the patients underwent MR plain and contrast-enhanced scan. Four patients with carotid body tumors and 2 patients with schwannomas underwent DSA examination. Results CT: Six carotid body tumors were lobulated soft tissue masses. The density of the tumors was similar to neck muscles. Two carotid body tumors involving jugular foramen expanded jugular foramen, and the margin was irregular and erosion-destructive. Five schwannomas were ovoid or fusiform soft tissue masses. The density of the tumors was mixed. Two schwannomas involved jugular foramen expanded jugular foramen, and the margin was smooth. MRI: Eight carotid body tumors were lobulated, well-defined, longitudinal growth masses with characteristic high-velocity flow voids. The tumor splayed and surrounded internal carotid artery and external carotid artery. The diameters of the arteries were normal. The tumors intensely enhanced on contrast-enhanced MRI. Eight schwannomas were ovoid or fusiform, well-defined, longitudinal growth masses with heterogeneous signal, splaying carotid artery and jugular vein. The diameters of the vessels were narrow. The tumors nonuniformly enhanced on contrast-enhanced MRI. DSA: Four carotid body tumors showed intense tumor blush, while 2 schwannomas showed slight tumor blush. Conclusion According to the imaging characteristic of the tumors, carotid body tumor and schwannoma in carotid space can be accurately differentiated.

Objective To investigate the CT and MRI findings of Coats’disease in comparison with pathology.Methods CT,MRI and ultrasonic features,FFA findings of eight patients of Coats’disease with histo-pathologically confirmed were analyzed retrospectively.CT scanning,routine MRI scanning and ultrasonic examination were performed in all eight patients.Results Unilateral eyeball was involved in all eight cases.On CT scanning,the density of the vitreous body was increased homogeneously which boundary was clear(n=8).The retina was thick(n=8).The anterior chamber depth was shallow(n=5).Multiple calcified foci occured in lens and vitreous body(n=1).The volume of affected eyeball increased(n=1).The affected eyeball shrinked(n=1).The difference of volume of bilateral eyeball was not obvious(n=6). Lens were thick and dislocation(n=5).On MRI scanning,the lesions in the vitreous body showed iso T1 and iso T2 signal (n=6),short T1 and long T2 signal(n=1),long T1 and long T2 signal(n=1).The retina showed short T2 signal(n=3).The vitreous body was filled with lesions(n=5).The lesions looked like‘V’sticked to retina(n= 3).On ultrasonic examination low echo was showed in the vitreous body(n=6),the ball wall bulged(n=8),retinal detachment(n=8).The echo of the ball wall was obviously enhanced,which indica-ted ossification(n=1).Strong echo calcified plaque was showed in one case.FFA showed retinal telangiectasia(n=8),retinal capillary zone(n=2),mutiple chestnut shaped aneurysms(n= 6),retinal neovascularization(n= 1 ).Pathological examination showed retinal telangiectasia with foam macrophages and lipid deposition.Conclusion Coats’disease carries some typical CT and MRI features.To summarize the radiologic features,the findings of FFA and ultrasonic inspection are helpful to diagnosis.