Objective To study CT and MRI manifestation of untypical cystic lymphangioma.Methods CT and MRI findings of 8 cases of cystic lymphangioma proved surgically and pathologically were analyzed retrospectively.7 cases were performed by CT and the other by MRI.Results 3 lesions are located at facies cranii,2 lesions at neck,2 lesions are located at mesostenium and 1 lesion is located at chest wall.CT and MRI findings include:(1)dense mass(5 cases);(2)lesion contain solid and water dense(2 cases);(3)lesion contain high dense hematoma(2 cases);(4)calcification in lesion(2 cases);(5)infiltrate the adjacent tissue(3 cases).Conclusion Most majority cystic lymphangioma can be identified by CT and MRI which also helpful to evaluation lymphangioma before surgical treatment.

Objective To evaluate the value of DWI in detecting active sacroiliitis in patients with axial spondyloarthritis ( SpA) .Methods DWI and conventional MRI examinations were done oblique coronary on bilateral SIJs of 19 participants,involving 8 patients (the case group) underwent clinical and conventional MRI evaluation for axial SpA active sacroiliitis and 11 healthy volunteers(the control group).The conventional MRI,DWI,ADC,EADC images were transmitted to two experienced radiologists respectively to read ,evaluate and measure ( the ADC values and EADC values ) at the workstation under the blind method .The experimental data were inputted and analyzed by statistics software .Results In the control group ,the periarticular bone marrow in the SIJ showed hopyintense signal on the DWI image ,hypointense signal on the ADC image and hyperintense signal on the EADC image .The periarticu-lar bone marrow oedema showed hyperintense signal on the DWI and ADC images , while hopyintense signal on the EADC image.At b values of 300s/mm2 ,the ADC values of the periarticular bone marrow oedema at each side in the case group were significantly higher than those in the control group , while EADC values were lower , the difference were statistically significant(Z=-3.115,-2.814,-3.002,-3.115,-3.115,-2.714,-2.889,-3.115,all P<0.05).Conclusion DWI can directly detect the signal changes ,extent of the periarticular bone marrow oedema , and analyze the severity of oedema quantitively ,which shows the utility in determining the activity and early diagnosis .

Objective To assess the value of spectral CT in differentiating benign and malignant serous cavity effusion in vitro.Methods 41 plastic tubes filled with serous cavity effusion underwent spectral CT imaging.The gemstone spectral imaging(GSI)viewer was used to measure the mean CT values of water -iodine concentration, iodine -water concentration,monochromatic images(40 -140KeV,interval of 5KeV),140KVp QC,and EFF -Z. Slope of spectral curve was measured also.Based on clinical and pathological diagnosis,30 cases of benign and 11 cases of malignant serous cavity effusion were compared.The difference of the spectral characteristic parameters was evaluated statistically by independent -samples t test using SPSS 18.0.Results The EFF -Z,water -iodine concentration,iodine -water concentration,and slope of spectral curve[7.26 ±0.25,(1 021.82 ±6.37)mg/mL, (-3.23 ±1.53)mg/mL,0.26 ±0.12]of benign serous cavity effusion showed no statistically significant differences between the malignant group[7.31 ±0.10,(1 016.17 ±5.32)mg/mL,(-3.06 ±1.18)mg/mL,(0.24 ±0.10), t =0.652,2.016,0.332,0.482,all P >0.05 ].There were statistically significant differences on 55 -140 KeV between the two groups[(4.87 ±7.13)and (10.66 ±6.70),(7.17 ±6.48)and (12.71 ±5.94),(9.58 ±6.11) and (14.96 ±5.65),(11.63 ±5.97)and (16.77 ±5.52),(13.31 ±5.93)and (18.36 ±5.52),(14.66 ± 5.98)and (19.52 ±5.52),(16.06 ±6.06)and (20.90 ±5.63),(17.03 ±6.10)and (21.42 ±5.88), (17.58 ±6.12)and (22.29 ±5.59),(18.05 ±6.14)and (22.74 ±5.49),(18.52 ±6.17)and (23.19 ± 5.51),(18.74 ±6.20)and (23.33 ±5.46),(19.16 ±6.20)and (23.80 ±5.47 ),(19.30 ±6.26 )and (23.87 ±5.45),(19.57 ±6.26)and (24.19 ±5.48),(19.66 ±6.28)and (24.21 ±5.43),(19.92 ±6.31) and (24.46 ±5.44),(20.00 ±6.32)and (24.53 ±5.43),t =2.339,2.474,2.544,2.489,2.456,2.356,2.301, 2.060,2.231,2.223,2.206,2.161,2.188,2.138,2.162,2.122,2.114,2.104,all P <0.05].However,there were no statistically significant differences on 40 -50 KeV[(-5.51 ±11.82)and (0.96 ±11.59),(-0.41 ±9.77) and (5.75 ±9.85),(2.47 ±8.21)and (8.19 ±8.11),t =1.559,1.785,1.984,all P >0.05].The difference be-tween benign and malignant effusion was statistically significant on 140KVp QC also [(10.25 ±6.96,16.60 ±6.84) (t =2.601,P =0.013)].Conclusion Some spectral CT characteristic parameters especially 55 -140 KeV mono-chromatic images can differentiate benign and malignant effusion.Spectral CT maybe afford a new method to differenti-ate benign and malignant effusion.

Objective To investigate the clinical,imaging,pathological and molecular biological features of mitochondrial encephalomyopathy with lactic acidosis and stroke -like episodes(MELAS)in children.Methods The clinical,imaging,pathological and molecular biological features of 1 2 children with MELAS diagnosed through muscle biopsy or gene sequencing in the Fifth Affiliated Hospital of Zhengzhou University from January 201 1 to December 201 5 were retrospectively analyzed.Results (1 )Clinical features:the main manifestations included headache and vomiting in 1 1 cases,epileptic seizures in 9 cases,short stature in 8 cases,hairy in 7 cases,intolerance fatigue in 7 cases,cogni-tive decline in 7 cases,visual disturbance in 6 cases,hearing disturbance in 6 cases,and 5 cases had positive family history.In addition,7 cases had the serum lactic acid level increase in a rest for 1 0 min after exercise.(2)Imaging fea-tures:4 cases showed bilateral basal ganglia calcification symmetry in 8 patients who underwent head CT scan.The most frequently involved parts of the lesion were occipital in 1 0 cases,temporal in 9 cases and parietal lobe in 7 cases in stroke -like episodes.The lesions were lamellar necrosis.The abnormal areas by MRI showed low signal intensity on T1 weighted imaging,high signal intensity on T2 weighted imaging and fluid attenuated inversion recovery,high or equal signal intensity on diffusion weighted imaging,high or low signal intensity on apparent diffusion coefficient;the lactate peak significantly increased on magnetic resonance spectroscopy.The distribution was not in accordance with the control region of the cerebral vessels.Dynamic observation revealed that the lesions were reversible and migratory.(3)Myo-pathological features:muscle biopsy was performed in all children,and ragged -red fibers were found in 1 0 cases by im-proved Gomori staining,strongly succinate dehydrogenase -reactive were found in 9 cases,and the lipid droplets slight-ly increased in 8 cases by oil red O staining.Besides,the crystalline inclusion bodies in mitochondria were arranged in a parking lotpattern in 9 cases by electromicroscope.(4)Molecular biological characteristics:the mitochondrial gene mutations were analyzed in peripheral blood of 9 children and their parents,including 8 cases with A3243G muta-tion and 1 case with G13513A mutation.Five mothers had the same A3243G mutation site in 8 cases.Conclusions Children with MELAS have complex and varied clinical manifestations and certain characteristic of neuroimaging.More-over,muscle pathology and gene sequencing have important diagnostic value.Fully understanding the clinical,muscle pathology,imaging and molecular biological characteristics of children with MELAS can be helpful to the early diagnosis and treatment,also reduce misdiagnosis.

Objective To investigate the effect of thyroid hormone(T3)on the expressions of cytochrome c (CytC) and apoptosis?inducing factor(AIF) after cerebral ischemia reperfusion injury in rats and its mechanism. Methods SD male rats were randomly divided into four groups: sham operation group(sham1),sham operation group + T3(sham2) ,ischemia?reperfusion group (IR) ,and thyroid hormone treatment group(T3). A rat model of cerebral ischemia?reperfusion injury was established by right middle cerebral artery occlusion for 2 h,followed by reperfusion for 24 h. Thyroid hormones (10μg/100 g) or normal saline were given at 1 h after onset of ischemia and 6 h after reperfusionby intraperitoneal injection. Neurological deficit scores were evaluated 24 h after reperfusion. Cerebral infarction volume was evaluated by TTC staining. Histological changes was observed by HE staining. Expressions and mRNA levels of CytC and AIF in ischemic brain tissue were evaluated by immunohistochemistry and real?time fluorescent quantitative RT?PCR. Results Ascompared with those in sham operation groups ,the expressions and mRNA levels of CytC and AIFincreased significantlyin IR groups. As compared with those in IR groups ,the indexes were remarkably decreasedin T3 groups (P < 0.01). Nerve function was markedly improved andinfarction area narrowed.Conclusions Thyroid hormone plays a certain role in protection of cerebral ischemia?reperfusion injury in rats,whose mechanism may be associated with inhibition of the expression of apoptosis factors?CytC and AIF.

Objective To investigate the effect of thyroid hormone on the expression of NF-κB and TNF-oα in the ischemic cortex of rats after focal cerebral ischemia-reperfusion.Methods 96 male SD rats were randomly divided into sham-operation group,sham-operation+T3 group,IR group and IR+T3 group.Using suture legal method to establish a rat model of middle cerebral artery occlusion for 2 h followed by reperfusion.In sham-operation+T3 group and IR+T3 group,T3 was given 3 days before ischemia and 1 hour after ischemia,respectively,intraperitoneal injection T3 10 μg/100 g for rats.Rats in other groups were given the same volume normal saline at the same time.The infarct size was determined by TTC staining at 24 h after reperfusion.HE staining was used to observe the morphological and structural changes of brain tissue.Using Real-time PCR method and immunohistochemical staining method to detect the expression of NF-κB mRNA,TNF-α mRNA and protein in ischemic cortex of rats.Results Compared with sham-operation group and sham-operation+T3 group,the pathological damage of brain tissue in IR group was obvious,while the pathologic damage of IR +T3 group was less than that in IR group.Immunohistochemistry assay showed that the expression of NF-κB was(49.19±5.55)in sham-operation group,(45.75±2.12) in sham-operation+T3 group,(56.88±2.23)in IR group and(50.25±1.67)in IR +T3 group,the expression of TNF-α was (22.50±3.07) in sham-operation group,(24.13±2.03) in sham-operation+T3 group,(37.25±2.82) in IR group and (30.25±1.67) in IR +T3 group,and the NF-κB,TNF-α in IR group were obviously higher than that in sham-operation group and sham-operation+T3 group(P＜0.05),while IR+T3 group were lower than that in IR group(P＜0.05).Real-time PCR showed that NF-κB mRNA,TNF-α mRNA level in IR group was the highest,which was higher than that of sham-operation group and sham-operation+T3 group(P＜0.05),and the NF-κB mRNA,TNF-oα mRNA expression in IR+T3 group were significantly decreased compared with that in IR group(P＜0.05).Conclusion Thyroid hormone has a protective effect on cerebral ischenia reperfusion injury,which may be achieved by reducing the expression of inflammatory factor NF-κB and TNF-oα.

Objective To investigate the neuroprotective effect of thyroid hormones T3 on cerebral ischemia-reperfusion injury in rats and its mechanism.Methods SD rats were divided into four groups:sham+saline group,sham+T3 group,MCAO+saline group,MCAO+T3 group.The cerebral ischemia-reperfusion injury rat models were established by right middle cerebral artery occlusion.Thyroid hormones(10 μg/100 g)or normal saline were given respectively by intraperitoneal injection twice at 1 h after the onset of ischemia and 6 h after reperfusion.Neurobehavioral score was evaluated at 24 h after reperfusion;TTC staining was used to label infarction area;RT-PCR was used to detect the mRNA level of nerve growth factor(NGF)and brain derived neurotrophic factor(BDNF)in brain tissue;Western blot was employed to determine alterations in protein levels of NGF and BDNF.Results Compared with MCAO+saline group,the neurological deficit and the volume of cerebral infarction of MCAO+T3 group was decreased,and the mRNA and protein expression of NGF and BDNF of MCAO+T3 group were increased(P<0.05).Conclusion Thyroid Hormones could promote the nerve repair,stimulate the nerve regeneration and improve the nervous behavioral function by up-regulating the expression of NGF and BDNF.

【Objective】 To evaluate the clinical efficacy and safety of one kind of human prothrombin complex concentrate in treatment of patients with hemophilia B. 【Methods】 The clinical data of 36 patients with hemophilia B treated with human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. from May 2018 to April 2019 were retrospectively analyzed, and its clinical efficacy and safety were analyzed. 【Results】 A total of 35 subjects entered the full analysis set (FAS)and safety set (SS), 33 subjects entered the per protocol Set (PPS). Thirty minutes after the first infusion of FAS subjects, the activity of coagulation factor Ⅸ increased from (3.93±0.975) IU/dL to (25.61±9.337) IU/dL, and the infusion efficiency was (96.43±22.007)%. The increased value of coagulation factor Ⅱ activity was (73.25±14.874) IU/dL. The activity of coagulation factor Ⅶ was (42.79±16.847) IU/dL. The increased value of coagulation factor Ⅹ activity was (65.29±17.042) IU/dL. The increased value of coagulation factor Ⅸ activity was (21.68±9.434%) IU/dL. Twenty-four hours after the first infusion of FAS subjects, the improvement of bleeding symptoms and signs was excellent in 21 cases (60%), improved in 14 cases (40.0%), and the effective rate was 100%. The incidence of adverse reactions was 2.9%(1/35), and there was no antibody to human coagulation factor Ⅸ and new virus infection. 【Conclusion】 Infusion of human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. in the treatment of hemophilia B has significant clinical efficacy and good safety.