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 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 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

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 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 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.

Objective To investigate the aggressive signs of benign spinal lesions appearing on medical imaging and their impact on diagnosis.Methods 139 cases of benign spinal lesions with aggressive signs confirmed by pathology of needle aspiration or surgery were reviewed,including 18 cases of osteoblastoma(OB),12 cases of aneurysmal bone cyst(ABC),14 cases of osteoenchondroma (OC),19 cases of Langerhans cell histiocytosis (LCH),15 cases of hemangioma (HA),34 cases of tuberculous spondylitis (TS),and 27 cases of pyogenic spondylitis (PS).All patients underwent radiography,119 cases CT plain scan,75 cases MRI scan,and 57 cases performed all the three imaging modalities.The aggressive signs,including bulging of posterior margin of the vertebral body,pathological compression fractures,ill-defined boundary,abnormal soft tissue mass,bone marrow and soft tissue edema were showed.The benign and malignant misdiagnosis rate,the consistent rate of diagnosis with pathology were statistically analysed.Results Bulging of posterior margin of the vertebral body were found in 2 cases of OB,1 case ABC,3 cases LCH,1 case OC,6 cases HA,6 cases TS,2 cases PS.Pathological compression fracture were found in 6 cases of OB,10 cases ABC,16 cases LCH,4 cases HA,21 cases TS,16 cases PS.Ill defined boundary were found in 3 cases of OB,8 cases HA,34 cases TS,27 cases PS.The abnormal soft tissue around spine were found in 6 cases of OB,2 cases ABC,15 cases LCH,10 cases TS,15 cases PS.Bone marrow and soft tissue edema were found in 5 cases of OB,4 cases ABC,10 cases LCH,4 cases HA,30 cases TS,27 cases PS.For benign and malignant misdiagnosis rate,MRI was better than CT(P＜ 0.05).For accuracy of the consistent rate with pathology,CT was better than MRI(P＜0.05).The integrated application of the three imaging methods could significantly improve diagnostic accuracy (P＜0.05).Conclusion The imaging features benign spinal lesions are various,which may be associated with aggressive signs.A comprehensive method combined with three kinds of imaging methods,is a simple and feasible way to avoid the misdiagnosis.

Objective To evaluate the clinical curative effect of Masquelet technique in treatment of infected single-bone defect of forearm.Methods The clinical data of 18 cases of forearm bone defect caused by bone infection in our department from January 2011 to June 2016 were retrospectively analyzed.All the patients received standard treatment of Masquelet technique with two stage.Radical debridement,bone defect filling with antibiotic PMMA bone cement, and internal fixation were accomplished at the first stage, and treatment of bone defect with autologous iliac bone graft were accomplished at the second stage after 6 to 8 weeks at the end of the first stage.The infection control,fracture healing and complications of the 18 patients were observed.Results There was no complications such as infection recurrence,bone resorption,plate screw loosening occured.The functional recovery of 18 cases in this group was evaluated according to the Anderson evaluation scale.The results were excellent in 9 cases,satisfactory in 6 cases,unsatisfactory in 3 cases,and no failure.The satisfactory rate was 83.33%.Conclusion Controlling infection with local release of antibiotics from PMMA bone cement implantation through Masquelet technique, inducing autogenous membrane structure in the bone defect area,and then transplanting autologous cancellous bone for bone defect reconstruction repair treatment are effective in the treatment of infected single-bone defect of forearm.

Objective To investigate X‐ray ,CT and MRI features of synovial chondromatosis of the temporomandibular joint (TMJ) .Methods X‐ray ,CT and MRI features of eight patients of synovial chondromatosis of TMJ with histo‐pathologically con‐firmed were analyzed retrospectively .X‐ray examination and CT scanning were performed in all eight patients .Routine MRI scanning was performed in six patients and contrast‐enhanced MRI scanning was performed in two patients synchronously .Results Tumors occured unilaterally in all eight cases ,which occured on the right TMJ in six cases and on the left side in two cases .On X‐ray films , widen joint space and calcificated loose bodies occured in all eight cases .On CT scanning ,cystic‐solid mixed mass around the joint and calcificated loose bodies occured in all eight cases .On MR scanning ,multiple nodular long T1 and short T2 signal occured in six cases . Arthroedema and synovial hyperplasia with iso T1 and iso or slightly long T2 signal in six cases .On contrast‐enhanced MR ,homoge‐neous enhancement occurred in svnovial tissue and the edge of loose bodies in two cases .Conclusion The synovial chondromatosis of TMJ owns typical imaging features .The imaging findings can serve as a reference to improve diagnosis of synovial chondromatosis of TMJ .