Facial Paralysis ; diagnosis ; etiology ; Humans ; Infant ; Leukemia, Myeloid, Acute ; complications ; diagnosis

In this paper,we analyzed one case of primary multifocal extranodal non-Hodgkin's lymphoma and reviewed the related literatures.We investigated the clinical data of this case with primary multifocal extranodal lymphoma and retrospected the related references.The key words,primary extranodal lymphoma and multifocal,were used to search Pubmed and Wanfang Database,and finally only three cases were found.The 68-yea-old woman was confirmatively diagnosed as primary multifocal extranodal B cell non-Hodgkin's lymphoma.The positron emission tomography/computed tomography (PET/CT) scan showed multiple hypermetabolic lesions in the left humerus,both kidneys and ileum.The confirmative diagnosis was based on clinical manifestations and serological tests,imaging features of CT and PET/CT,and especially on the histopathological and immunohistochemical studies.After one cycle chemotherapy (rituximab,Vincristine and prednisone) and another cycle (rituximab,Vincristine,cyclophosphamide and prednisone),a repeat PET/CT scan showed a complete metabolic resolution of the lesions in the kidneys and ileum,and a partial metabolic resolution of the left humerus.After four cycles of chemotherapy,there were new extensive involvements of the right supraclavicular and intrapulmonary lymph nodes,bilateral pleural and pericardium,and the patient gave up chemotherapy.This case demonstrated the imaging findings of an uncommon primary multifocal extranodal lymphoma in left humerus,both kidneys and ileum,and highlighted the usefulness of CT and PET/CT scan in identifying the extent of disease involvement,in guiding a biopsy,and in assessing the treatment response of lymphoma.It is essential to differentiate between primary multifocal extranodal lymphoma and lymphoma extensive metastases.

Objective To explore the value of three antibodies in the differential diagnosis of papillary thyroid carcinoma ,by de‐tecting the expression of HBME‐1 ,CK19 and CD117 in papillary thyroid cacinoma ,thyroid follicular adenoma and Hashimoto′s thy‐roiditis tissues .Methods Totally 85 cases were collected from January 2013 to December 2015 ,including papillary thyroid cacino‐ma ,thyroid follicular adenoma and Hashimoto′s thyroiditis .They were immunohistochemical stained by HBME‐1 ,CK19 and CD117 .SPSS16 .0 software was used to analyze the relationship between the staining results with different pathological changes . Results The positive rates of HBME‐1 ,CK19 and CD117 were 87 .3% ,98 .2% ,and 7 .3% ,respectively .The positive expression of them in benign and malignant groups had significant difference (P< 0 .05) and their consistency checking Kappa were 0 .582 , 0 .551 ,and 0 .874 ,respectively .Conclusion In the differential diagnosis of papillary thyroid carcinoma and benign lesions ,CD117 is better than HBM E‐1 and CK19 .It′s possible to use a combination of them in practice .

Objective To explore the value of MRI histogram analysis in the risk assessment of medulloblastoma recur rence.Methods The data of 28 patients pathologically confirmed of medulloblastoma was analyzed retrospectively.All patients were divided into recurrent group and the non recurrent group (each n=14).The ROIs were drawn on the maximum level of enhanced MR sagittal images,and the histogram analysis were performed using the software named Mazda.The statistical analysis was performed on the histogram parameters to find out the different characteristics between the two groups,and the ROC curve was drawn to evaluate its diagnostic efficacy for recurrence of medulloblastoma.Results In all of the 9 parameters which are extracted from histogram,kurtosis had statistical significance between the 2 groups (P=0.018).The area under the ROC curve was 0.776 (P=0.018),and the sensitivity and specificity of kurtosis in the risk assessment of medulloblastoma recurrence were 64.3％ and 71.4％,respectively.Conclusion MRI histogram analysis can be an important method to assess the risk of medulloblastoma recurrence.

Objective To investigate mental health literacy (MHL) of community medical staffs in district and town of Zhongshan city,and to provide data to improve MHL of community medical staffs.Methods Totally 352 medical staffs who were not psychiatric physician and 81 psychiatric physician were selected.The Chinese Mental Health Knowledge Awareness Questionnaire (published by Ministry of Health) was used to investigate the awareness rate of mental health knowledge.Five vignettes of two schizophrenia,one bipolar disorder,one depression and one obsessive compulsive disorder,each with 8 related questions,were used to investigate the recognition and response ability.Results The average awareness rate of the two groups was more than 80.0% (87.6%,91.6%).For the item 2(75.6%,88.6%),6(74.1%,62.6%),19(36.5%,65.6%),and 20(74.1%,86.2%),the awareness rates were lower than 80.0%,and there were significant differences between the two groups (x2=8.45,4.92,27.48,6.99,all P<0.05).In vignettes survey,the correct rate was lower in the staffs who did not engaged in the mental health work than those in the other group,the difference was statistically significant(64.6% vs.75.9%,P<0.001).For both of the two groups the correct rate of depression was the lowest(x2=44.46,P<0.001).There was statistically significant difference between the total (x2=141.17,P<0.001).Conclusion The awareness rate of mental health knowledge has reached the national standards for community medical staffs,but they have to improve for some knowledge point.Their recognition and response ability for mental illness should be improved.

To screen the harmful substance 5-hydroxymethyl furfural content in commercially available traditional Chinese medicine injection which are commonly used, and to preliminarily evaluate the quality of these injections, 5-hydroxymethyl furfural was taken as an index. The contents of 5-hydroxymethyl furfural in 56 samples which consist of 23 kinds of traditional Chinese medicine injections and glucose injection were determined using LC-MS/MS, and 5-hydroxymethyl furfural was detected in 52 of these samples. The minimal content was 0.0038 microg x L(-1) and the maximum content was 1420 microg x mL(-1). The contents of 5-hydroxymethyl furfural were significantly different in traditional Chinese medicine injection which came from different kinds, manufacturers or batches. The results showed the quality difference of commercially available traditional Chinese medicine injection is significant taking 5-hydroxymethyl furfural content as assessment index. More attention should be paid to the safety of 5-hydroxymethyl furfural in traditional Chinese medicine injection, and unified limitation standard should be set to improve medication safety of traditional Chinese medicine injection.

Objective To improve the diagnosis of oligodendroglioma(OD)in cerebellar hemispheres and discuss MRI features. Methods Clinical and imaging data of 7 cases with OD in cerebellar hemispheres were analyzed retrospectively,which were confirmed by surgery and pathology.Results In 7 patients,4 patients were OD,and 3 patients were anaplastic oligodendroglioma(AOD).MRI showed hypointense on T1WI and vividly hyperintense or mixed hyperintense on T2WI.The time intensity curve(TIC)manifested rise slowly;DWI(b=1 000 s/mm2) showed homogeneously hypointense or iso-hypointense.The ratios of OD and AOD were 1.753±0.784,1.660±0.551 respectively;Magnetic resonance spectroscopy(MRS)of oligodendrogliomas revealed a increased choline(Cho)and reduced N-acetylaspartate(NAA)without lactate(Lac)peak.Conclusion MRI manifestation of OD in cerebellar hemispheres has certain characteristics:the boundary of lesion is unclear, irregular in shape,easy to cystic and necrotic,with or without peripheral edema of the tumor,delayed enhancement,higher in Cho peak,lower in NAA peak and lacking in Lac peak.

Objective To explore the MRI features of cavernous hemangioma in the thoracic spinal epidural space,to improve the recognition of the disease.Methods The clinical,pathological and MRI data of 7 cases with cavernous hemangioma in the thoracic spinal epidural space confirmed by surgery and pathology were analyzed retrospectively.Results 7 cases of cavernous hemangioma in the thoracic spinal epidural space were included in our study,all cases underwent MRI contrast enhancement examination and 6 of them underwent conventional MRI examination.On T1WI,4 cases showed hypointensity,2 cases showed slightly hypointensity and 1 case showed mixed slightly hypointensity.On T2WI,5 cases showed slightly hyperintensity,1 case showed slightly hypointensity. On fat suppression sequence,5 cases showed hyperintensity,1 case showed heterogeneous hyperintensity.On diffusion-weighted imaging (DWI),7 cases showed obviously hyperintensity.On contrast-enhanced images,the lesions enhanced homogeneously in 5,enhanced heterogeneously in 2.Conclusion MRI can display the location,appearance and enhancement pattern of thoracic spinal epidural cavernous hemangioma distinctly,while definite diagnosis of which still depends on pathology.

Objective:To investigate the application value of oxygen-challenge MRI in the identification of ischemic penumbra in acute middle cerebral artery occlusion (MCAO) model in rats.Methods:Fifty-eight SD rats were received MCAO processing. Ten MCAO rats were randomly selected. MRI scanning was performed and modified neurological severity score mNSS was evaluated before and after oxygen stimulation at the 1st, 3rd, 6th and 12th hour after MCAO model preparation. The scanning data before and after oxygen stimulation were recorded as air group and oxygen group respectively. T 1 values and T 1 change rate of different brain regions were measured. Twenty-four MCAO rats were selected for oxygen stimulation according to the above four time points. At each time point, 3 MCAO rats were randomly selected for HE staining and recorded as oxygen stimulation group 1 ( n=12). Meanwhile, 3 MCAO rats were randomly selected for immunohistochemical examination at each time points to determine the expression of protein kinase C receptor (RACK1), recorded as oxygen stimulation group 2 ( n = 12). Another 24 MCAO rats were selected without oxygen stimulation. Among them, three MCAO rats were randomly selected at each time point for HE staining, recorded as non-oxygen stimulation group 1 ( n=12); and three MCAO rats were randomly selected at each time point for immunohistochemistry to detect the expression of RACK1, recorded as non-oxygen stimulation group 2 ( n=12). Independent sample t-test was used for the comparison between the two groups. One way ANOVA was used for the comparison in T 1 change rate between different brain regions, and repeated measurement ANOVA was used for the comparison of T 1 change rate in the same brain region at different time points. The correlation between the expression of RACK1 protein in oxygen group 2 and non-oxygen group 2, as well as T 1 values in air group and oxygen group was analyzed by Spearman analysis. Results:At the same time point, the difference of mNSS scores between air group and oxygen group was statistically significant ( P<0.05). At different time points, the difference of mNSS between the two groups was also found statistically significant ( P<0.05). There were significant differences in T 1 values and T 1 change rate between air group and oxygen group in ischemic core area, mismatched area and contralateral normal area, among which the difference was statistically significant (all P<0.05). At different time points, the cellular edema or vacuolation in the cerebral ischemic area of 24 MCAO rats in the oxygen challenge group 1 and the non-oxygen challenge group 1 showed an aggravating trend, and the degree of cellular edema or vacuolation in the cerebral ischemic area of the non oxygen challenge group 1 was slightly less degree than that of the non-oxygen challenge group 1. The expression of RACK1 protein in the cerebral ischemia area of 24 MCAO rats in the oxygen challenge group 2 and the non-oxygen challenge group 2 decreased at different time points, and the expression of RACK1 protein in the non-oxygen challenge group 2 was higher than that in the oxygen challenge group 2 ( P<0.05). Conclusions:Oxygen challenge MRI can be used to determine the oxygen metabolism in the brain infarction tissue of MCAO rats. The oxygen challenge MRI T 1 value and T 1 change rate can help to identify the ischemic penumbra of MCAO rats. Oxygen stimulation may delay the development of cerebral ischemia. The expression of RACK1 plays a protective role in acute cerebral ischemia and is related to the development of hypoxia in brain tissue.

Objective To study the value of whole tumors volume based apparent diffusion coefficient histogram analysis in grading diagnosis of ependymoma. Methods Seventy?one patients with ependymal tumors were retrospectively analyzed, including 13 cases of WHOⅠ, 28 cases of WHOⅡ, 30 cases of WHO Ⅲ. Regions of interest (ROI) in the apparent diffusion coefficient maps of three groups on each layer of tumor level were drawn by using MaZda software and were analyzed using the whole tumors gray histogram. The histogram parameters of the three groups all fitted the normal distribution and homogeneity test of variance. The ANOVA analysis was used to compare the three groups. LSD-t test was used to compare the two groups to find out statistical significance of each parameter. Results Through histogram analysis of 9 parameters, three parameters were statistically significant (P<0.05), including variance, perc. 01％ and perc. 10％. The remaining 6 parameters had no significant difference between the three groups (P>0.05). Between the WHOⅠand the WHOⅡ, the sensitivity of perc.10％was 85.7％, the specificity was 87.7％, the area under the curve was 0.835, and the best cut-off value was 131.33. Between the WHOⅠand the WHOⅢ, the sensitivity of perc.10％was 85.7％, the specificity was 100.0％, the area under the curve was 0.872, and the cut-off was 126.5.Between the WHOⅡand the WHOⅢ, the sensitivity of variance was 68.4％, the specificity was 79.6％, the area under the curve was 0.794, and the cut-off was 2645.7. They had a high identification efficiency. Conclusion Whole-tumor histogram analysis of apparent diffusion coefficient maps could provide ancillary diagnostic value in grading diagnosis of ependymoma. Perc.10％and variance had a high diagnostic efficiency.