Objective To explore enhanced MRI diagnostic value of CPA(cerebellopontine angle) tumors.Methods 68 cases of CPA tumors,including acoustic neuromas(n=34),trigeninal neuromas (n=5),meningiomas(n=20)and cholesteatomas(n=9),proved surgically and pathologically were studied.All patients were performed MR scans before and after contrasted-enhancement on axial,sagittal and coronal plane.Results 23 of 34 acoustic neuromas showed nodule-ring-like,wreathlike or mutilocular enhanced masses;11 were homogeneous masses.The facial-hearing nerve bundle were markedly thickened and enhanced in 34 cases and in which 15 presented "water-chestnut"sign;suggesting it was a typical appearance of acoustic neuromas.5 trigeminal neuromas manifested nodule-ring-like or multilocular enhanced masses(n=3),and dumbbell-like masses(n=2).20 meningiomas exhibited homogeneous massive enhancement,"dural tail"sign(n-11),the facial-hearing-nerve bundle on the affected side were enhanced but not thickened(n-5);which represented reactive changes to the tumors.9 cholesteatomas displayed long T 2 long T 1,no enhancement;spreaded along subarachnoid space and basilar artery encapsuled(n-5).Conclusion Enhanced MRI can reveal the characteristics of CPA tumors,it is of especial value for diagnosis of the tumors.

AIM: To compare the release and percutaneous penetration in vitro among 2 kinds of the psoralen ointments and its gel. METHODS: Dissolution tester and Franz diffusion cells were adopted as the release and percutaneous penetration in vitro, and HPLC was used to measure the amount of psoralen in the releasing solution, receiving solution and the skin. RESULTS: The release and percutaneous penetration of psoralen from the 3 kinds of preparation conformed to the zero kinetic equation. The steady-state penetration rate of psoralen in the gel was higher than that of the ointment, and there was no significant difference between 2 kinds of ointments. CONCLUSION: Gel is a better choice for percutaneous penetration of psoralen.

Objective To study the imaging features of meningiomas of ethmoid sinuses. Methods Six cases of meningiomas of ethmoid sinuses verified pathologically were analyzed retrospectively. Results CT scans of 6 cases exhibited huge cystic masses ( n =3), huge cystic solid masses ( n =2), huge solid mass ( n =1). The cystic walls were remarkable osteosclerosis. The density of solid masses were homogeneous, or heterogeneous with calcifications and cystic changes, and prominent contrast enhancement. MR images of 1 case (1/6) showed a cystic solid mass, the cystic portion was highsignalintensity on T 2WI and lowsignalintensity on T 1WI, while the solid mass was isosignalintensity on T 1WI and T 2WI. The solid portion was enhanced. X ray plain films of 3 cases (3/6) displayed ethmoid sinuses enlargement and high density. Conclusion For the meningiomas of ethmoid sinuses, CT finding was specific, MRI was helpful in differential diagnosis, and X ray plain film was of no qualitative value.

Objective To explore the expression and significance of hsa-miR-181a (miR-181a) in can-ceration progression of endometrial carcinoma. Methods A total of 75 formalin-fixed paraffin-embedded tissue specimens were studied in this study , of which , 13 were normal endometrium , 18 were endometrial hyperplasia , 44 were endometrial carcinoma. After total RNA had been extracted , real-time PCR was applied to detect the ex-pression level of miR-181a in endometrial tissue in each group. Results miR-181a expression in formalin-fixed paraffin-embedded tissue specimens can be detected. Expression of miR-181a in endometrial carcinoma was high-er than that in endometrial hyperplasia , its expression in endometrial hyperplasia was also higher than that in normal endometrium, and the difference was statistically significant (P < 0.05). The expression of miR-181a in endometrial carcinoma was associated with FIGO stages (P < 0.05). Conclusion The up-regulation of miR-181a expression in women with endometrial carcinoma may play the role of oncogenes. Abnormal expression of miR-181a is probably associated with the occurrence and development of endometrial carcinoma.

Objective To explore the effect of modified Seldinger technology in PICC intubation for chemotherapy . Methods Forty patients with chemotherapy during January to December 2014 were assigned as the control group, where the traditional PICC intubation was used, and another forty patients during January to December 2014 as the observation group, where modified Seldinger technology was used. The two groups were compared in terms of post-intubation comfort, puncture success rate, bleeding rate and complications. Results The post-intubation comfort degree of the observational group was significantly higher than that of the control group (P<0.05). The total puncture success rate and one-time success rate were both statistically significantly higher than those of the control group, and the rates of obstruction and infection were significantly lower than those of the control one (P<0.05). Conclusion Modified Seldinger technology used for intubation for chemotherapy can help improve comfort degree and safety and reduce the rate of complications.

Objective To determine the capability of emergency physicians (EPs) after goaldirected training to make accurate judgement and assessment of left ventricular systolic function (LVSF) as they own manipulated the hand-held echocardiography.Methods Eighty-one patients with acute dyspneic symptom admitted into emergency department of Xinhua Hospital Affiliated to Shanghai qaotong University School of Medicine from November 2011 to February 2012 were enrolled for a prospective,observational study.Patients with a history of trauma or acute myocardial infarction diagnosed by electrocardiogram were excluded.Four EPs after a intensive course of goal-oriented training in a good command of trans-thoracic echocardiography (TTE) in 81 emergency patients using hand-held echocardiography.EPs attempted to obtain images at the parasternal (long and short axis),apical,and subcostal positions,and visually estimated left ventricular ejection fraction (LVEF) and categorized LVSF as normal function,mild or moderate or severely depressed function.The results of echocardiographic LVEF got by EPs were compared quntitatively with those measured by an professional echocardiographer.The kappa statistical test by using SPSS version 13.0 software was used to allow for comparison in agreement between EPs and the professional echocardiographer's interpretations of TTE findings.Results Using the results of TTE measured by the professional echocardiographer as agold standard,EPs correctly distinguished the normal LVSF from decreased LVSF in 89％ patients.The rate of positive predictive value for the EPs identifying any abnormality in LV function was 83％ and the rate of negative predictive value was 93％.The kappa coefficient for the agreement between EPs and the professional echocardiographer' s interpretations for any abnormality in LV function was 0.77 (95％ CI:0.70-0.84,P ＜ 0.01).EPs correctly placed LV function into one of three categories in 68 of 81 cases (84％),The kappa coefficient for the agreement was 0.71 (95％ CI:0.64-0.78,P ＜0.01).Conclusions Emergency physicians after a intensive course of training in mastering echocardiography can accurately determine the left ventricular systolic function.

Objective To investigate serological blood typing of the ABO locus which contradict to general law of inheritance in parentage,and the underlying reasons for severe hemolytic disease of newborn(HDN).Methods To research the family whose newborn is AB phenotypes,mother is O phenotypes and father is AB phenotypes.The familiy were genotyped by parentage tests, serological tests,PCR-SSP and direct DNA sequencing at exons 6 and 7 of ABO gene.At the salne time,HDN was detected by micro column gel Coombs (MGCT), and the primary fingerposts of the routine blood tests. Biochemical tests were dynamically observed.Results The results of parentage tests showed that three-generation pedigree have parent-child relationship. The red blood cell(RBC)of this AB phenotypes of this family members strongly agglutinated(4+)with diverse monoelonal anti-A and anti-B antibodies,and their serum did not contain anti-A and anti-B antibodies in blood anti-typing.PCR-SSP can not detect their A and B gene,but DNA sequencing at exons6 and 7 of ABO gene revealed that it had the B(A)803C→G mutation.Conclusions The genetm basis of this parentage are B(A)803G blood gene which harbored both A and B difunctionality of glyeosyhransferases.This was the first report that severe HDN resulting from a large number of A and B antigens in RBC of B(A)phenotype of a newborn,which has clinical significance on ABO locus.

Objective To explore the expression of serine/threonine kinase 15 (STK15) gene and its significance for papillary thyroid carcinoma. Methods SP immunohistochemical method was used to detect the expression of STK15 gene in 71 cases of papillary thyroid carcinoma and 45 cases nodular goiter tissue. Results The positive expression rates of STK15 gene in 71 cases of papillary thyroid carcinoma were 100%, and the adjacent of papillary thyroid carcinoma expressions of STK15 gene 8.5%, nodular goiter tissue of STK15 gene expression rates 24.4%. The expression of STK15 gene was positively correlated with that of STK15 gene in papillary thyroid carcinoma (P < 0.01). Conclusion High expression of STK15 gene is confirmed in papillary thyroid carcinoma. The detection of STK15 gene can provide valuable evidence for diagnosis of papillary thyroid carcinoma and evaluation of the malignant potential of nodular goiter.

Objective To evaluate the feasibility of T2 *mapping T2 *value combined with DWI ADC value in quantitative assessment of the activity of sacroiliitis.Methods 30 patients diagnosed with ankylosing spondylitis (AS)were divided into 2 groups as acute group (n=17)and chronic group (n=13)according to the BASDAI scores of the clinical severity of disease.And 20 healthy adults were recruited as control group.All groups were examined by MR with traditional sequence,T2 *mapping and DWI in the sacroiliac joint.The T2 *value and ADC value of the bone marrow edema region and normal region were measured.Furthermore,the imaging data and the clinical scores were statistical analysis and compared among three groups.Results T2 *values and ADC values in acute group of AS patients were higher than chronic group (P<0.05),as well as compared with healthy volunteers (P<0.05).There was no statistically significant difference between the chronic group of AS patients and control group (P>0.05).Positive correlation between ADC value and BASDAI was observed in patients group.Conclusion T2 *mapping combined with DWI imaging in AS is beneficial for early diagnosis and quantitative analysis of the activity of sacroiliitis.

Objective To investigate the cause of fracture nonunion and discuss the experience of locking plates fixation combined with autoallergic cancellous bone in the management of non-infective long bone nonunion.Methods A retrospective analysis was made in 38 patients(29 males and 9 females)with fracture nonunion treated with locking plates fixation combined with autoallergic cancellous bone from August 2006 to August 2010.Of all,22 patients were treated with plates and 16 with interlocking intramedullary nails.Results All the patients were followed up for a mean of 12 months(range,6-24 months).The bone union time for all the fractures averaged 5.3 months(range,3-7 months),with no complications like implant loosening or fracture.Conclusions Iatrogenic factor is the main cause for fracture nonunion after open reduction and internal fixation of long bone fractures and the locking plates combined with autoallergic cancellous bone are a safe and effective treatment procedure.