Objective To analyze the roentgenographic findings of the osteopetrosis. Methods Nine patients with clinically suspected osteopetrosis underwent the X-ray examinations of the chest,skull,pelvis,vertebral column,femur,tibiofibula,bones of upper limb and bilateral handbone. The roentgenographs of all patients were analyzed together with review of the literature. Results The basic image feature of osteopetrosis is bone density increased notably,cortible bone thickening,cavum ossis narrowing or occluded and mark X-ray signs include sandwich change in back bone,concentric rings change in pelvis,bone within a bone change,bright-dark alternation transverse striation in metaphysis of tubiform bone,baseball club appearance due to modelling deformity of long bones and periosteal new bone formation. Conclusion Osteopetrosis is a rare inherited disorder. Its mark roentgonographic findings are important evidence for performing the definite diagnosis and differential diagnosis.

Objective To investigate clinical and pathologic features of hypertension patients with adre -noeorticotropic hormone ( ACTH)-independent adrenal hyperplasia , and to analyze the relationship between them . Methods The data of patients with ACTH-independent adrenal hyperplasia and hypertension was collected in Department of Urology , the First Affiliated Hospital of Zhengzhou University from Jan .2012 to Dec.2012.The clinical manifestations , endocrine examination results , imaging findings and the pathological changes of adrenal gland were retrospectively analyzed .Results 75 cases were followed-up.Among them, 39 cases were male and 36 were female.Their ages ranged from 20 to 74 years(with 47 as the average).Pathological results showed that diffusive hyperplasia was observed in 42 cases, tubercle hyperplasia in 26 cases, mixed corticomedullary patho-logical changes in 6 cases, and medullary hyperplasia in 1 case.No significant difference was found among diffu-sive, tubercle and mixed corticomedullary hyperplasia in clinical manifestations except for headache , endocrine examination results, or imaging findings(P>0.05).Conclusion There is no relation between clinical manifes-tations, endocrine examination results , imaging findings and pathological changes in adrenal gland for patients with ACTH-independent adrenal hyperplasia and hypertension .

ObjectiveTo assess the surgical results and implications of clinicopathologic features on the prognosis of patients with hepatic matastases from gastric adenocarcinoma. MethodsNinety one of 834 patients with primary gastric cancer were diagnosed with synchronous ( n =79) or metachronous ( n =12)hepatic metastases. Twenty-one cases underwent hepatectomy for the metastasis. Results The actuarial 1-year, 3-year survival rates after hepatic resection were respectively 69% and 30%. Solitary and metachronous metastases were significant determinants for a favorable prognosis after hepatic resection. Pathologically, tumor pseudomembrane was found in 13 out of 21 patients which was associated with a favorable prognosis. ConclusionsSolitary and metachronous hepatic metastases from gastric cancer should be treated by a surgical approach which confers a good prognosis. The formation of pseudomembrane of the metastatic tumor predicts a favourable postoperative survival.

Objective To study the characteristics of the solid pseudopapillary tumors of the pancreas (SPT) ,and to improve the diagosis and management of SPT. Methods Fourteen cases of solid pseudopapillary tumors of the pancreas admitted from Jan 1999 to Jul 2005 were analyzed retrospectively. Results There were 1 male and 13 females. Tumors were all single and mainly located in the head of the pancreas (9/14, 64. 3% ) , tumors in the other 5 cases were in the body and tail of the pancreas. The average diameter was 7.2 cm, with no specific symptom. On CT scan tumors were of low density, well-circumscribed with calcification, solid tumors were enhanced slightly on contrast medium, but cystic tumors were not enhanced . Simple resection was performed in 8 cases. Partial resection of the body of the pancreas and pancreaticojejunostomy was performed in 2 cases. One patient underwent distal pancreatectomy and splenectomy. Pancreaticoduodenectomy was performed in 3 cases. All the cases were followed up for an average of 20. 1 months with no recurrences. Conclusions Solid-pseudopapillary tumor of the pancreas is of low-grade malignancy. Surgical resection is effective. Surgical procedures adopted depend on the location and size of the tumor. Complete resection results in good prognosis.

Objective To investigate the related risk factors of the previous cemented vertebral body re-wedge after percutaneous kyphoplasty (PKP).Methods In this retrospective case-control study,clinical data of 617 patients treated by PKP from December 2008 to November 2014 were analyzed.According to whether the cemented vertebra wedged again,the patients were divided into cemented vertebral re-wedge group (n =12) and non-cemented vertebral re-wedge group (n =605).The data of age,preoperative bone density,preoperative vertebral osteonecrosis,intraoperative bone cement injection amount,postoperative bone cement leakage,postoperative bone cement filling,postoperative recovery rate of vertebral wedge angle,and presence or absence of adjacent old vertebral wedging were recorded in two groups.All patients were followed up for one year,and the data were summarized and statistically analyzed.Results Single factor analysis showed the factors of whether there were adjacent old vertebral wedge,preoperative vertebral osteonecrosis,cystic bone cement filling,different wedge angle recovery rate,and emergence of previous cemented vertebral body re-wedge after PKP were statistically significant between two groups (P ＜ 0.05).There was no obvious statistical difference in age,preoperative bone density,intraoperative bone cement injection amount,and intervertebral bone cement leakage between two groups (P ＞ 0.05).Multivariate Logistic stepwise regression analysis showed cystic bone cement filling,preoperative vertebral osteonecrosis,adjacent old vertebral wedging,and higher recovery rate of vertebral wedge angle were prone to appear previous cemented vertebral body rewedge (P ＜ 0.05).Conclusions Relatively higher recovery rate of vertebral wedge angle,previous adjacent old vertebral wedge,vertebral osteonecrosis,and cystic bone cement filling are risk factors closely related to cemented vertebral re-wedge after PKP,which gives a good reference to assess surgical risk,avoid risk factors and choose right surgical techniques.

Objective ToexplorethevalueofMR DKIinevaluationofmicrostructuredamageincervicalspinalcordinjury(CSCI) Methods 32casesofCSCIpatientsconfirmedbyclinicalexaminationand20casesofhealthycontrolgroupwereinvestigatedbyconventional MRIandDKIexamination.AccordingtoT2WIsignal,theinjurygroupweredividedintoA,Bgroup,Agroupofhighsignalgroup(n＝14)andBgroupofnegativegroup (n＝18).A,BgroupsandcontrolgroupweremeasuredbyFA,meandiffusivity(MD)and mean kurtosis(MK)valuesatdifferenttimes (acute,4 weeksafterinjury,2to3 monthsafterinjury)andthedata wereanalyzedby SPSS17.0statisticalsoftware.TheROCcurvewasusedtoevaluatetheabilityofdifferentparametersindiagnosingCSCI.Results In A,BgroupsFAvaluesdecreasedearlyandincreasedgradually,butwerealwayslowerthanthecontrolgroup,andthedifferencewas statisticallysignificant(P＜0.001).InAgroup MDvalueincreasedearlyanddecreasedgradually,butwashigherthanthecontrol group (P＜0.001).InAgroup MKvaluedecreasedearlyandincreasedsignificantly(P＜0.001).InBgroup MDvalueincreasedand MKvaluedecreasedintheacutephase(P＜0.001),lateron MDand MKvaluesgraduallytendtothecontrolgroup,thedifference wasnotstatisticallysignificant(P＞0.05).Conclusion DKIcannoninvasivelyreflectthemicroGdamageofCSCI,whichcannotbedisplayed byconventionalMRIfortheearlydetectionofspinalcordabnormalities.TheFAvalueisofhighdiagnosticvalue.

Objective To explore the changes in diffusion kurtosis imaging(DKI)and diffusion tensor imaging(DTI)parameters and their relationship with cognitive ability in patients with mild traumatic brain injury(mTBI).Methods Forty-one mTBI patients(mTBI group)and 40 normal controls(normal control group)were examined by head MRI.Fractional anisotropy(FA),mean diffusivity(MD)of DTI parameters and mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),fractional kurtosis anisotropy(FKA),axonal water fraction(AWF),axial extra-axonal dispersion(AxEAD),radial extra-axonal dispersion(RadEAD)and tortuosity(TORT)of DKI parameters were calculated in region of interest(ROI).MMSE and Montreal cognitive assessment(MoCA)were used to evaluate the cognitive ability of the two groups.Results Compared with those in normal control group,AK in all lesion areas in mTBI group were increased,AWF,RK,AxEAD and RadEAD,FKA,MK were decreased(all P<0.05).Compared with those in normal control group,FA of pontine,corpus callosum and posterior limb of internal capsule in mTBI group were significantly decreased(all P<0.05);MD of putamen,posterior limb of internal capsule and thalamus in mTBI group were significantly increased(all P<0.05).Pearson correlation analysis showed that FKA was positively correlated with MMSE score at enrollment(r=0.81,P<0.05)and MMSE,MoCA scores at 3 months of treatment(r=0.88,r=0.89;all P<0.05).FA was positively correlated with MoCA score at enrollment and 3 months of treatment(r=0.82,P<0.05;r=0.76,P<0.05).MK was correlated with MMSE and MoCA scores at enrollment(r=0.77,r=0.76;all P<0.05)and 3 months after treatment(r=0.90,r=0.90;all P<0.05).MD was positively correlated with MMSE score at 3 months after treatment(r=0.90,P<0.05).Conclusion DKI combined with DTI can determine the degree of lesion by reflecting the changes of brain tissue microstructure,and is positively correlated with the cognitive ability of TBI patients.

Objective: To study the effects of metastasis associated 1 (MTA1) on biological characteristics such as migration, invasion and proliferation of gastric cancer (GC) cells. Methods: pSilencer3.1-MTA1-siRNA vector was used to establish human gastric cancer BGC-823 cell lines with constitutive MTA1-knockdown. Boyden, wound healing, clony forming assay and 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) assay were performed to identify the effects of MTA1-deficiency on the biological behaviors of BGC-823 cells in vitro. Simultaneously, MTA1 overexpressed BGC-823 cell line was established by pcDNA3-MTA1 plasmid transfection for reverse verification. In addition, the role of MTA1 in the tumorigenicity of gastric cancer BGC823 cells in vivo was examined by subcutaneous injection of BGC-823 cells expressing different MTA1 levels into nude mice. Reverse transcription-polymerase chain reaction (RT-PCR) and western blot were used to detect the expression levels of integrin β1, cyclin D1 and uPAR in pSilencer3.1-MTA1-siRNA, pcDNA3-MTA1 transfected cells and control cells. Results: MTA1 knocked down or upregulated BGC-823 cell lines were successfully generated by transfecting pSilencer3.1-MTA1-siRNA or pcDNA3-MTA1 vector with lipofectamine 2000, respectively. The Boyden and wound healing experiments showed metastasis and invasion ability in MTA1 knocked down cells (25±2, 12±1) were significantly decreased when compared with those of control (78±2, 50±2) and MTA1-overexpressed groups (218±2, 269±3; P<0.05). The results of MTT assay and colony forming assay were significantly decreased when compared with those of showed that MTA1 overexpressed cells grew more rapidly and formed more colonies in vitro and induced worse malignant tumors in vivo, while MTA1 knocked down cells presented the reversed phenotype[control group (1 482.41±511.90) mm^3, (1.39±0.29)g; MTA1 overexpressed group [(3 158.73±1 823.22) mm^3, (2.23±0.51)g; MTA1-downregulated group (711.32±284.30)mm^3, (0.87±0.21) g ; P<0.05)]. In addition, RT-PCR result showed that the expression level of MTA1 was positively correlated with the known metastasis-related genes (integrinβ1, cyclinD1, uPAR). Conclusions MTA1 promotes the invasion, migration and proliferation of human gastric cancer BGC-823 cells. On the contrary, down-regulation of MTA1 significantly inhibits tumorigenicity of BGC-823 cells and induces favorable phenotypes. MTA1 may promote the malignant phenotype of BGC-23 cells via regulating the expressions of integrinβ1, cyclinD1 and uPAR.

Objective: To investigate the safety and feasibility of laparoscopic remedial surgery in patients who didn′t reach the cure criterion of early colorectal cancer after endoscopic resection. Methods: The clinical and follow-up data of 12 patients who didn′t reach the cure criterion of early colorectal cancer and then underwent endoscopic resection was collected. The clinicalpathological features and remedial indications were analyzed to evaluate the effects of laparoscopic remedial surgery. Results: The average number of lymph nodes in the lymph node dissection was 15 during remedial surgery, and 3 of them had lymph node metastasis. Among the 3 patients with residual cancer, two cases were poorly differentiated, 1 case was moderately differentiated, 1 case was positive for basal margin, and 1 case had vascular invasion. No lymph node metastasis occurred in the 9 patients who had no residual cancer. Among these, 8 cases were moderately differentiated, 1 case was poorly differentiated and 2 cases had positive basal margin. The average follow-up duration was 40 months and all 12 patients were in a state of survival at the last follow-up. During the follow-up of the 3 patients with residual cancer, 1 patient received adjuvant chemotherapy with unknown prognosis; 1 patient received postoperative adjuvant radiochemotherapy, and lung metastasis occurred; 1 patient did not receive any treatment after surgery and survived for 33 months. Conclusions Laparoscopic remedial surgery is a safe and feasible remedy for patients who didn′t reach the cure criterion of early colorectal cancer after endoscopic resection. However, the choice of remedial strategy for colorectal carcinoma needs further investigation for patients with no vascular invasion, high degree of differentiation, and negative basal margin.