Objective To observe the clinical efficacy of ozone injection combined with extracorporeal shock wave in treatment of arthritis of perishoulderr.Methods 120 patients with arthritis of perishoulderr and treated were choiced,they were randomly divided into two groups.Patients in group C were performanced extracorporeal shock wave treatment.Patients in group H were performanced with ozone injection combined with extracorporeal shock wave.Visu-al analogue score(VAS)and rane of motion(ROM)were used to evaluate the therapeutic effect.Results There was no significant difference between the two groups preoperation.Then significant difference of VAS in the two groups for 1week,1 month,3 months and 6 months after treatment showed respectively as (4.56 ±0.27)points vs.(2.49 ± 0.25)points,t =43.57,(3.96 ±0.23)points vs.(1.86 ±0.29)points,t =43.95,(3.36 ±0.20)points vs.(1.79 ± 0.25)points,t =36.51,(3.98 ±0.23)points vs.(2.09 ±0.27)points,t =41.29,P <0.05;The ROM data were respectively(55 ±18)points vs.(67 ±16)points,t =3.86,(60 ±20)points vs.(72 ±18)points,t =3.45,(56 ±19) points vs.(78 ±15),t =7.04,(46 ±18)points vs.(77 ±14)points,t =10.53,P <0.05.Patients feeled pain eased significantly in group H was significantly higher than group C in 6 month postoperativeiy.(χ2 =38.90,P <0.01;χ2 =8.91,P <0.05).Conclusion There is significant effect in patients with arthritis of perishoulderr treated by com-bined ozone injection with extracorporeal shock wave.

Objective To investigate the characteristics of transperineal pelvic ultrasounds among middlelate gestational women and study the the correlation between middle-late gestation and stress urinary incontinence.Methods Seventy-four pregnant women at a gestation of 14-40 weeks were divided into the incontinence group (n =34) and the non-incontinence group (n =40).The bladder neck angle,the bladder neck rotation angle,the bladder neck movement degrees,the posterior urethra-vesical angle,and the urethral rotation angle at both inactivity and maximum Valslva activity were evaluated by pelvic ultrasound.The acquired data were treated and analyzed with t-test and correlation analysis with with P ＜ 0.05 considered statistically significant.Results Compared with the non-incontinence group,the bladder neck rotation angle,BND,bladder neck angle and posterior urethra-vesical angle during the maximum Valsalva activity in the incontinence group were all significantly larger (P ＜ 0.05).A moderate correlation between urethral rotation angle and gestation week in the incontinence was observed (P ＜ 0.05).Conclusion The changes of the supportive structures around bladder urethreal tissues in middle-late gestation women are obvious.The urethral rotation angle becomes larger with the gestation going on.

Background and purpose: As the most common tracer used for PET/CT to detect malignant tumors. ~(18)F-fluorodeoxyglucose (~(18)F-FDG) can reflect the metabolism of glucose. However, there exists physiologic uptake in the intestinal tract of healthy people. Because ileocecal foci is predilection site of malignant tumors and inflammatory disease, the purpose of this study was to investigate the discrimination of PET/CT detection of incidental ileocecal high FDG uptake. Methods: We retrospectively analyzed 28 unexpected ileocecal focal uptake of ~(18)F-FDG localized by PET/CT, and then semi-quantitatively analyzed the extent of radioactive uptake in ileocecal foci. After PET/CT, the etiology of the findings was confirmed histologically by surgery, endoscopic or by long-term follow-up. All the data were assessed for statistical significance using one-way ANOVA. Results: In all the ileocecal foci, there were 14(50%) physiologic FDG uptake, 8 (28.6%) benign diseases and 6 (21.4%) malignant tumor. Maximal standardized uptake value was 5.2±1.6 in physiologic uptake, 6.8±4.1 in benign lesions and 12.8±5.5 in malignant lesions. There was statistically significant difference between malignant tumors and the other 2 groups. According to ROC analysis, when SUN_(max) was 6.75, the sensitivity and specificity of ileocecal malignant tumor were 100% and 86.4%, respectively. Conclusion: The significant value of discrimination between benign and malignant lesions of ileocecal focal FDG uptake by PET/CT was affirmative. It is very important to recognize physiologic uptake of ileocecal conjunction in the interpretation of image. Semi-quantitative analyze was not helpful to identify benign lesions from physiologic uptake.

Objective To explore the value of MRS and DWI in diagnosis of cervical spinal cord injury.Methods The MRI plain scan images of 95 cases who suffering from cervical spinal cord injury were analyzed.They were divided into two groups according to the T2 signal of cervical cord,63 cases in Group A(incomplete injury group)with no abnormal on T2 ,32 cases in Group B(complete injury group)with high signal on T2 .The other 50 cases with no injury of cervical cord were recruited as control group (Group C). All the cases were performed with MRS and DWI.The N-acetyl aspartic acid(NAA),choline compounds(Cho)and creatine(Cr)as well as the peak area of lactic acid (Lac)on MRS,and apparent diffusion coefficient(ADC)on DTI were measured separately.Mean-while,NAA/Cho,NAA/Cr,Cho/Cr,Lac/Cho and ADC were analyzed.Results On MRS sequence,the values of NAA/Cho and NAA/Cr were lower in Group B (P <0.05)when compared with Group A.The values of NAA/Cho and NAA/Cr were also lower in Group B,when compared Group C.However,the value of Lac/Cho in Group B was higher than it in Group C(P <0.05).When com-pared Group A with Group C,the value of Lac/Cho only increased in the former.However,on DWI,the value of ADC in Group A was(0.79±0.1 7)×10 -3 mm2/s,lower than that of Group C(0.93±0.1 5)×10 -3 mm2/s (P =0.026);the value of ADC in Group B was(1.21±0.20)×10 -3 mm2/s,significantly higher than that of Group C(P =0.01 7).When compared with Group B,the value of ADC in Group A was a lightly lower (P =0.143)with no statistical significance.Conclusion MRS can noninvasively and quantita-tively reflect the changes of metabolism of medium in injured cervical cord and help characterize the severity and degree of cervical cord injury from metabolic and molecular level.DWI has high sensitivity on early diagnosis of cervical cord injury.The combination of MRS and DWI has important value for formulating reasonable treatment plan and prognostic evaluation.

Brexanolone, also known as 3a, 5a-tetrahydroprogesterone, is a metabolite of progesterone and an important neuroactive steroid with a wide range of biological activities.Recently, the most exciting thing is that 2019 year the FDA has approved its treatment of postpartum depression, which is also the only drug to obtain indications for postpartum depression.It is expected to officially enter the market by the end of June 2019 year.This article reviews the research progress of its pharmacological action.

Objective To explore the value of cMRI and MRS in diagnosis and differential diagnosis of single brain metastases and localized high grade gliomas.Methods The cMRI (T1WI,T2WI and contrast-enhanced MRI)and MRS data of 23 cases with single brain metastases and in 28 cases with high grade gliomas confirmed by pathology were collected and analyzed retrospectively.Results cMRI:①There were no significant differences of T1WI,T2WI and constrast-enhanced MRI between single brain metastases and high-grade gliomas.②Enhanced images of single brain metastases and localized high-grade gliomas showed that there was a significant difference in the peritumoral edema area:the nodular or ring enhancement were found in single brain metastases,the outer outline of ring enhancement was smooth,and there was no enhancement at the peripheral edema area;Irregular patchy or ring enhancement were found in localized high-grade glioma tumor,both of the outer and inner edges of the ring enhancement rough,a little patchy enhancement at the peripheral edema area were found in 1 6 patients,and there was no enhancement of the edema area in the other 1 2 patients.MRS:①There were no significant differences of the tumor parenchyma in the peaks of NAA,Cr,Cho and central Lac between single brain metastases and localized high grade gliomas.②A significant difference of the peripheral edema area were observed between them.The peaks of NAA,Cr,Cho at the edema area in all single brain metastases patients were normal.But in all high-grade glioma patients,the NAA and Cr peaks were decreased,while the Cho peaks were increased.Conclusion The morphological manifestations of single brain metastases are similar to localized high grade gliomas.An obvious difference of cMRI and MRS lines exists in the peritumoral edema area between them,which could be used for differential diagnosis.

INTRODUCTION: Childhood radiation exposure is a known risk factor for thyroid malignancy and dysfunction. However, local data are limited and there is no consensus on the modality and frequency of screening in this high-risk group. METHODS: Retrospective analysis study evaluating patients with childhood radiation exposure in 2006-2016 and minimum of 1-year follow-up. RESULTS: Of the 132 childhood cancer survivors in the study, thyroid malignancy was detected in 2 cases (1.5%) and thyroid nodules in 13 (9.8%). The earliest thyroid malignancy was detected 5 years post-radiotherapy via ultrasound. Of the 84 patients who had screening thyroid function test, 26 (31.0%) were detected with abnormal test results post-radiation, majority being subclinical hypothyroidism. CONCLUSION Regular screening via clinical examination for thyroid nodules should be performed at least annually. Where feasible and if resources permit, consideration should be given to using ultrasound for thyroid nodule(s) and malignancy screening at 5 years post-radiation therapy. Screening for thyroid dysfunction can be considered from 6-12 months post-radiotherapy.

Background and objective Lung cancer is a common malignancy and is the major determinant of overall cancer mortality worldwidely. Approximately 70％ of lung cancer patients will die from metastatic diseases. The aim of this study is to establish a Chinese lung adenocarcinoma cell line with high metastasis potency for exploring the mechanism of occurrence and development in lung cancer. Methods The cell came from the pericardial effusion of a fifty-year old male patient with lung adenocarcinoma and the cells in primary culture were obtained successfully. Immunodeficient mice tumorigenidty was assayed. The cell growth curve was mappinged Analysis of chromosome karyotype was tested. Tumor marker was detected by radioim-munoassay.The gene expression was measured by real-time quantitative PCR. Results The first passage cells were planted in im-munodeficiant mice subcutaneously and the tumorigenesis rate was 100％ as well as later passages. Under the microscope, the cell showed larger and semi-suspension, semi-adherence. Approximately 0.8x 106 cancerous ceils were injected into left cardiac ventri-cle or tail vein of immunodeficient mice resulted start to appear lower limb paralysis and spine swelling deformation in the mice after inoculation two-three weeks. The bone metastasis rate was 90％ in the tumor bearing mice by bone acintigraphy and pathol-ogy and only pulmonary metastasis 10％ at the same time. The chromosome karyotype analysis of the cells was sub-triploid. The tumor marker CEA was detected in higher secretion by radioimmunoassay in the cell culture suspension. Quantitative real-time PCK was used to examined and compared SPC-A-1 lung adenocarcinoma, VEGF-C, IL-6,IL,-8, genes were overexpressed. The novel cell line was named CPA-Yang1. Conclusion Tne novel strain CPA-Yang1 is an parental cell with characteristics of bone metastasis of Chinese lung adenocarcinoma. It has stable traits, highly metastatic ability and a good experimental modal for lungcancer research.

Objective To apply PDCA(plan,do,check and action)cycle to optimize management and shorten the turnaround time(TAT)of five sex hormone tests for improving clinical efficiency and patient satisfaction.Methods A PDCA management team was established to retrospectively analyze the current status of sex hormone TAT in 2021.In 2022,PDCA tools were utilized,including fishbone diagrams for cause analysis,Pareto charts for root cause identification,formulation and implementation of corresponding im-provement measures and monitoring of TAT changes before and after PDCA.Results Through the corrective measures,such as staff personnel training,increasing testing equipment,optimization process and other improvement measures,the median TAT of sex hor-mone samples in 2022(post-PDCA improvement)was 54 minutes which was significantly lower than 61 minutes in 2021(pre-PDCA)(P＜0.05).Conclusion PDCA cycle management effectively shortened the TAT of sex hormone samples,enhanced clinical diagnostic efficiency and patient experience,improved doctor-patient relationships,while also elevated the quality management standards of labo-ratories.

Introduction: Derangement in calcium homeostasis is common in nephrotic syndrome (NS). It is postulated that low serum total calcium and vitamin D levels are due to loss of protein-bound calcium and vitamin D. It is unclear if free calcium and free vitamin D levels are truly low. The guideline is lacking with regards to calcium and vitamin D supplementation in NS. This study aims to examine calcium and vitamin D homeostasis and bone turnover in NS to guide practice in calcium and vitamin D levels supplementation. Methodology: This is a prospective pilot study of ten patients diagnosed with NS, and eight healthy controls. Calcium, vitamin D, and bone turnover-related analytes were assessed at baseline, partial and complete remission in NS patients and in healthy controls. Results: NS patients had low free and total serum calcium, low total 25(OH)D, normal total 1,25(OH)D levels and lack of parathyroid hormone response. With remission of disease, serum calcium and vitamin D metabolites improved. However, nephrotic patients who do not attain complete disease remission continue to have low 25(OH)D level. Conclusion In this study, the vitamin D and calcium derangement observed at nephrotic syndrome presentation trended towards normalisation in remission. This suggested calcium and vitamin D replacement may not be indicated in early-phase nephrotic syndrome but may be considered in prolonged nephrotic syndrome.
Vitamin D Deficiency