Objective To investigate the values of diffusion tensor MR imaging(DTI)and fiber tractography(FT)in the assessment of cognitive functions in children with periventricular leukomalacia (PVL),to facilitate to understand the mechanism of PVL children's cognitive functions.Methods Forty six children with PVL and 16 age-matched volunters were recruited.Developmental quotient(DQ)of all cases was recorded.According to the DQ scores,patients were divided into 3 groups:mild in 11 patients,moderate in 19,and severe in 16.DTI was performed in all cases and fractional anisotropy(FA)values were be calculated.Non-paired t test was used to compare the FA values of major white matter fibers between patients group and controls group.One-way ANOVA was used to compare the FA values among 4 groups.Results Compared with controls,all 46 patients with PVL showed a significant mean FA reduction in left corticospinal tract(CST)(0.476 ±0.064 vs.0.531 ±0.064),bilateral anterior limb of internal capsula (ICAL)(left 0.357 ±0.050 vs.0.405 ±0.081,right 0.370 ±0.040 vs.0.405 ±0.036),posterior limb of internal capsule(ICPL)(left 0.483 ±0.044 vs.0.546 ±0.091,right 0.485 ±0.046 vs.0.547 ±0.083),arcuate fasciculus(AF)(left 0.367 ± 0.069 vs.0.433 ± 0.097,right 0.363 ± 0.064 vs.0.421 ±0.091),posterior thalamic radiation(PTR)(left 0.390 ± 0.059 vs.0.459 ± 0.067,right 0.382 ± 0.047 vs.0.446 ± 0.064),anterior CG(ACG)(left 0.362 ± 0.056 vs.0.423 ± 0.057,right 0.345 ± 0.056 vs.0.417 ± 0.080),superior longitudinal fasciculus(SLF)(left 0.323 ± 0.050 vs.0.426 ±0.102,right 0.341 ± 0.056 vs.0.416 ± 0.092)and splenium of the corpus callosum(SCC)(0.535 ±0.090 vs.0.606 ±0.060)(t =2.037-3.745,P ＜0.05).The severity of cognitive impairment companied with decrease of the FA values of all fibers.The FA values of bilateral CST,ICAL,ICPL,left AF,bilateral PTR,ACG,SLF and SCC were significantly different among different groups(F =3.021-7.146,P ＜ 0.05).Conclusions The damage widespread of white matter bundles is found in children with PVL DTI and FT can provide details in the assessment of cognitive impairment in children with PVL.

OBJECTIVETo study the histogenesis, pathologic features and differential diagnosis of prostatic primary signet ring cell carcinoma.

METHODS10 cases of the primary signet ring cell carcinoma were detected from 262 cases of prostate carcinomas diagnosed on needle biopsy were investigated by routine pathological, immunohistochemical and histochemical methods, and then compared with 10 cases of signet ring cell carcinomas of the stomach and colon. 3 cases were studied with electron microscopy.

RESULTS9 cases of prostate signet ring cell carcinoma were associated with concurrent high-grade conventional prostatic carcinoma, but at least 25% of the neoplasm consisted of signet ring cells. Only one case was pure signet ring cell carcinoma. Neoplastic signet ring cells may be divided into two types: the first type showed formation of intracytoplasmic lumina or vacuole, and the second type had intracytoplasmic accumulation of excess PSA and/or PAP. Both types of signet ring cells were negative for mucin staining (AB/PAS and mucicarmine). Therefore they differed from signet ring cell carcinomas of the stomach and colon.

CONCLUSIONSPrimary prostate signet ring cell carcinoma is a low-differentiated adenocarcinoma of a special histologic type, which arises from the epithelial cells of the prostate acinus. They can be distinguished from metastatic signet ring cell carcinoma of the stomach and colon and also from vacuolate degeneration of conventional carcinoma after endocrine or radiation therapy.

Carcinoma, Signet Ring Cell ; pathology ; Cell Differentiation ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Male ; Microscopy, Electron ; Middle Aged ; Prostatic Neoplasms ; pathology

Objective To investigate the correlation between the mean platelet volume (MPV) ,neutrophil-to -lymphocyte(NLR) and the severity as well as prognosis of sudden sensorineural hearing loss (SSHL) patients . Methods A retrospective cohort study involved 172 patients with SSHL from January 2012 to May 2015 .The distri-bution characteristics of routine blood (white blood cells ,neutrophil ,lymphocyte ,MPV ,NLR) in different audio-metric curves (hearing loss at low frequencies ,flat type ,high frequencies ,and total deafness) and prognosis of re-covery (complete ,partial ,slight ,and no recovery )were analyzed by SPSS 19 .0 analysis chi square test ,and the prognosis was estimated by using the receiver operating characteristic curve (ROC) .Results MPV and NLR levels in the severe and profound hearing loss group were significantly higher than that in different audiometric curves (P<0 .01 and P<0 .01) .MPV and NLR level in the partial recovery group and the no recovery group were signifi-cantly higher than that in the complete recovery group (P<0 .01 and P<0 .01) .The value of the MPV and NLR showed negative correlation with the prognosis (hearing recovery ) ,and the lymphocyte was positive with the prog-nosis .The sensitivity and specificity of MPV and NLR count 24 hours after admission predicting the prognosis of hearing recovery were 66 .2％ and 85 .5％ ,58 .4％ and 86 .7％ ,respectively .Conclusion The changes of MPV and NLR in SSHL patients are related to the severity of hearing loss ,and NLR count at 24 hours after admission may play an important role in prognosis of this disease .

Objective:To investigate the perioperative impact of closure of mesenteric fissure in laparoscopic right hemicolectomy.Methods:The prospective randomized controlled trial was conducted. The clinical data of 320 patients who underwent laparoscopic right hemicolectomy in 11 medical centers, including The First Affiliated Hospital of China Medical University et al, from November 2022 to August 2023 were selected. Based on block randomization, patients were alloca-ted into the mesenteric fissure non-closure group and the mesenteric fissure closure group. Observa-tion indicators: (1) grouping of the enrolled patients; (2) intraoperative conditions; (3) postopera-tive conditions. Measurement data with skewed distribution were represented as M( Q1, Q3) and com-parison between groups was conducted using the Mann-Whitney U test. Count data were represen-ted as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher's exact probability. Comparison of ordinal data was conducted using the rank sum test. Comparison of visual analog scores was analyzed using generalized estimating equations. Results:(1) Grouping of the enrolled patients. A total of 320 patients with colon cancer were screened for eligibility, including 156 males and 164 females, aged 68(59,73)years. All the 320 patients were allocated into the mesenteric fissure non-closure group with 164 cases and the mesenteric fissure closure group with 156 cases. There was no significant difference in the age, body mass index, American Society of Anesthesiologist score, maximum tumor diameter, anastomosis location, anastomosis method, surgical approach, range of lymph node dissection, tumor staging between the two groups ( P>0.05) and there was a significant difference in the sex between them ( P<0.05). (2) Intraoperative conditions. There was no significant difference between the mesenteric fissure closure group and the mesenteric fissure non-closure group in the volume of intraoperative blood loss, operation time, conversion to laparotomy, intraoperative complication ( P>0.05). Three patients in the mesenteric fissure non-closure group were converted to laparotomy. One patient in the mesenteric fissure closure group was converted to laparotomy, and 2 cases with intraoperative complication were mesenteric hematoma. (3) Postoperative conditions. There was no significant difference between the mesenteric fissure non-closure group and the mesenteric fissure closure group in the overall postoperative complications ( χ2=0.28, P>0.05). There was no significant difference in the occurrence of postoperative intestinal obstruction, abdominal distension, ascites, pleural effusion, gastric paralysis, anastomotic bleeding, anastomotic leakage, or surgical wound infection between the two groups ( P>0.05). There was no significant difference between the two groups in the reoperation, postoperative gastric tube replacement. There was no significant differ-ence in time to postoperative first flatus, time to postoperative initial liquid food intake, time to post-operative resumption of bowel movements, duration of postoperative hospital stay, total hospital expenses between the two groups ( Z=-0.01, 0.43, 1.04, -0.54, -0.36, P>0.05). One patient in the mesenteric fissure non-closure group received reoperation. No perioperative internal hernia or death occurred in either group. The visual analog score decreased with time in both groups. There was no significant difference in the visual analog score between the mesenteric fissure closure group and the mesenteric fissure non-closure group [ β=-0.20(-0.53,0.13), P>0.05]. Conclusion:Compared with closure of mesenteric fissure, non-closure of mesenteric fissure during laparoscopic right hemi-colectomy dose not increase perioperative complications or postoperative management risk.