BACKGROUND:Pathological change and compression of multiple vertebra often occur following senile osteoporosis,myeloma and metastatic tumor.However,there are few studies concerning treatment of multiple vertebral lesion shaping.OBJECTIVE:To explore therapeutic efficacy,announcements of multiple pathological thorax-lumbar vertebrae treated with once only percutaneous vertebroplasty (PVP).DESIGN,TIME AND SETTING:The observational experiment.Patients were selected from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital from November 2004 to October 2008.PARTICIPANTS:A total of 31 patients from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital with senile osteoporosis combined with compression fracture,general lymphadenomatosis of bones and osteolytic metastatic tumor,14 males,17 females,with an age of 56-82 years old.METHODS:Thirty-one cases of multiple pathological thorax-lumbar vertebrae were treated with PVP.Following local anesthesia,affected vertebral body underwent vertebrae root puncturation.Under strict monitoring,bone cement was injected into the vertebral body in order.Following surgery,vertebral body condition and patients' reaction were observed.Therapeutic efficacy was evaluated 1 week following surgery.MAIN OUTCOME MEASURES:The following parameters were measured:centrum puncture success ratio,disposable centrum forming number,bone cement injection quantity,centrum bone cement distribution situation,leakage of bone cement to soft tissue and vein surrounding the vertebra,ache alleviation,and complications.RESULTS:A total of 75 vertebroplasy was used 33 times,2 vertebral bodies at least once only,and 5 vertebral bodies at most once only,with an average of 2.27 vertebral bodies once only.4-12 mL of bone cement was injected in each vertebral body,averagely 7.5 mL.Uniformity injection was done in 49 cases,and partial injection in 26 cases.Without serious complications,all the patients relieved in local pain parts following surgery.Significant remission or disappearance was determined in 20 cases,and partial remission in 11 cases.CONCLUSION:PVP is a safe and effective method in treatment of multiple pathological thorax-lumbar vertebrae.The key of operation is reasonable injection and thorough monitoring.

Objective To analyze the changes of relaxation values of different brain gray matter nuclei in patients with Parkinson's disease(PD)by synthetic magnetic resonance imaging(SyMRI),and to explore the correlation between relaxation values and clinical subtypes of PD,so as to provide some imaging basis for the diagnosis and classification of PD.Methods A total of 53 patients with PD and 34 healthy controls(HC)were scanned by SyMRI sequence.The patients with PD were divided into early group(33 cases),middle and late group(20 cases),postural instability/gait difficulty(PIGD)group and tremor dominant(TD)group.The region of interest(ROI)was drawn manually and the T1,T2 and proton density(PrD)values of different brain gray matter nuclei were measured,respectively.The differences between the groups were compared.Results There were statistical differences between the PD group and the HC group in multiple gray matter nuclei and multiple relaxation value parameters(P＜0.05).There were statistical differences in the relaxation values of gray matter nuclei such as head of the caudate nucleus,body of the caudate nucleus,putamen,globus pallidus,thalamus,red nucleus,and substantia nigra among the early PD group,the middle and late PD group,and the HC group,and red nucleus PrD value had the most testing effectiveness in the diagnosis of early PD[area under the curve(AUC)0.823,P＜0.001].There were statistical differences in the relaxation values of gray matter nuclei such as head of the caudate nucleus,putamen,and thalamus between the PIGD group and the TD group(P＜0.05).Conclusion It is found that there are statistical differences in different nuclear relaxation values between PD patients and healthy people,as well as between PD patients with different clinical types via SyMRI,suggesting that SyMRI has a certain clinical value in the diagnosis and classification of PD.

Abernethy malformation， also known as congenital portosystemic shunts， is rare in clinical practice， with less than 300 cases reported in the global literature up to 2019. The disease can have serious complications such as pulmonary hypertension， liver tumor， and liver failure and tends to have an extremely poor prognosis， and early diagnosis and active and effective treatment can reduce and delay the onset of complications. In this case， portography combined with balloon occlusion helped to display the underdeveloped slender portal vein with dysplasia， so that the child who was formerly misdiagnosed with type Ⅰ Abernethy malformation was diagnosed with type Ⅱ Abernethy malformation， and then the child was successfully treated by transcatheter closure. This article gives a detailed report of this case.