Objective To further explore the relationship between increasing genetic material and clinical manifestation of partial trisomy 5p .Methods G‐banding karyotypes of peripheral blood lymphocytes in the patient and his parents ,and at the same time to summary the partial trisomy 5p clinical performance .Results patient ,46 ,XX ,der(6)t(5 ;6)(p13;q25) mat ;partial trisomy for 5p13→pter resulting from the balanced translocation of the mother .Mother:46 ,XX ,t(5;6)(p13 ;q25);carrier of a balanced 5/6 translocation .Father :46 ,XY .Conclusion The phenotype of trisomy 5p may be associated with express and function of gene at spe‐cial chromosome region .

Objective To investigate the direct and indirect MRI manifestations of anterior cruciate ligament(ACL)tears and discuss its mechanism and diagnostic value.Methods The study involved 40 patients with ACL tears including 37 males and three females at age range of 16-49 years(mean age of 33 years).Arthroscopy and operation confirmed 28 patients at acute phase of ACL tears,12 at chronic phase of ACL tears,35 with complete ACL tears and five with partial ACL tears.All patients were examined on 1.5T Siemens MRI scanner,with SE,TSE or Medic sequence in multiple directions.The direct and indirect MRI manifestations of ACL tears were retrospectively and statistically analyzed by employing three experienced doctors.Results Among 28 patients with acute tears,the direct MRI signs included signal interruption or non-consecutive(86%),uneven signal(64%)and swelling and thickening ligament(36%).While in 12 patients with chronic teats,the MRI signs manifested swelling ligament(92%),signal interruption or non-consecutive(75%)and uneven signal(58%).The sign of thickening ligament was mainly seen at chronic phase of ACL tears(P ＜0.01).Of 35 patients with complete ACL tears,80% occurred in the middle part of ACL,with low incidence of upper and lower parts.All five patients with partial ACL tears occurred in the anteriomedialis bundle.The indirect MRI signs of ACL tears included 7-shaped deformity of posterior cruciate ligament(PCL)(34 patients,85%),meniscus exposure(26 patients)including 16 with lateral meniscus exposure(62%),bone injury(15 patients)including segond fracture(8 patients,53%),widened joint space(9 patients)including 78% at chronic phase,and tibia antelocation(23 patients,57%).Among 40 patients,37 patients were diagnosed correctly preoperatively,with accuracy rate of 92%.While three patients with partial ACL tears were missed diagnosis preoperatively,with inaccuracy rate of 8%.Conclusion ACL tear is relatively easy to identify preoperatively according to direct and indirect MRI signs in combination with trauma history.

Purpose To analyze the perfusion differences of different pancreatic diseases using the low-dose whole organ dynamic volume CT perfusion imaging, and to provide the evidence for the clinical application. Materials and Methods Twenty-eight patients suspected as pancreatic disease were applied by 640 layer volume CT perfusion imaging for the pancreas. Data were collected at the same time of bolus injection of contrast agent, then were analyzed by spatial alignment and perfusion calculation using the perfusion software. The time-density curve, blood perfusion flow diagram and tissue artery blood flow were obtained using the maximum slope method. Results Normal pancreatic tissue (n=9) blood flow was (117.04±12.05) ml/(min?100 ml), pancreatitis organizations (6 cases with acute pancreatitis and 3 cases with chronic pancreatitis) (118.67±37.18) ml/(min?100 ml), pancreatic carcinoma tissue (n=10) was (67.16±18.94) ml/(min?100 ml). There was significant difference among three groups (F=8.59, P<0.001);the difference was demonstrated in pancreatic cancer vs. normal pancreas and pancreatic cancer vs. pancreatitis group (q=3.70, P<0.05), which could be clearly demonstrated by blood perfusion flow diagram. The difference was not statistically revealed pancreatitis and normal pancreas group (q=2.91, P>0.05). The total dose of X-rays in the whole scanning process was 21.5-23.9 mSv. Conclusion Low-dose whole pancreas organ CT perfusion scan can quantitatively analyze the hemodynamic changes in pancreatic disease, which be of great value for evaluating changes in microcirculation during the treatment of pancreatic cancer.

Objective To report 2 cases of Fabry disease with early-onset ischemic stroke and investigate the clinical and image features. Methods The 2 patients developed dizziness, diplopia and progressive memory decline at 32 and 25 years of age respectively. The α-galactosidase A (GLA)activity was 4. 3 U in case 1 and 1. 0 U in case 2 ( normal range 100-500 U). Skin biopsy showed numerous membrane bounded osmiophilic laminar material in vascular smooth muscle cells and endothelial cells. GLA gene analysis revealed GLA exon 7 1033-1034 TC del in case 1 and GLA exon 3 466G ＞ A in case 2. The 2 patients were evaluated by Mainz severity score index (MSSI) and cranial MRI. Results The general MSSI was 32 in case 1 and 16 in case 2, with the highest score of neurological score ( 11 and 14). Both cases showed multifocal infarcts in bilateral cerebellum, occipital lobe, basal ganglia, which were hypointensity on T1 WI and hyperintensity on T2WI. There were hyperintensity changes in the pulvinar and basal ganglia on T1 WI in case 2. Conclusions Cerebral ischemic stroke could appear as initial symptoms in Fabry disease,which predominantly involved the posterior circulation. There might be no dilation of basal-vertebral artery.

Objective Toinvestigatetheoperativeeffectandsafetyofendovascularstentingfor thetreatmentofsymptomaticvertebralarteryostialstenosis.Methods Fortypatientswithsymptomatic vertebral artery ostial stenosis and stenosis rate ≥70% were admitted to the Department of Neurology, China-Japan Friendship Hospital from November 2010 to January 2013 were enrolled retrospectively. All patients received endovascular stenting therapy,15 of them were implanted bare metal stents,and 25 were implanted drug eluting stents. The technical successful rate of operation,perioperation complications,and symptom remission rate of the patients were analyzed. At the same time,stroke and death incident as well as the related ischemic symptoms of the stent vascular feeding area in the follow-up period (13 to 36 months)wereobservedandtherestenosisratewasdocumented.Results Atotalof42stentswereimplanted in 40 patients,and the technical success rate was 100. 0%. The preoperative stenosis rate of vertebral artery ostial stenosis was 75% to 99%(mean 85 ± 7%);the postoperative stenosis rate was 0% to 20%(mean 6 ± 4%). There was no perioperative complication. The clinical symptoms of 19 patients disappeared completely,16 were improved significantly within the follow-up period,and the symptom remission rate was 87. 5%. No stent vascular feeding area related stroke and death occurred. Four patients had transient ischemic attack in posterior circulation,13 had restenosis after procedure (10 of them with bare mental stents and 3 with drug eluting stents). There was significant difference in restenosis rate between the bare mental stents andthedrugelutingstents(10/15vs3/25,P=0.001).Conclusion Endovascularstentingforthe treatment of the severe symptomatic vertebral artery ostial stenosis is a safe and efficient method. Although its restenosis rate is high,but it can improve the symptom of posterior circulation ischemia effectively.

Objective:To investigate the variation characteristics and influencing factors of HIV/AIDS subtypes in Wuxi city of Jiangsu Province from 2014 to 2016.Methods:HIV/AIDS population in Wuxi city in 2014 was selected as the research object, and the HIV molecular epidemiology and follow-up study were carried out. Collect epidemiological information, extract DNA from blood samples, amplify pol gene fragment by nest-PCR and sequence, use ChromasPro 1.6 software and MEGA 7.0 software to construct the HIV-1 sequence database, and use FastTree2.1.10 software to construct the phylogenetic tree to confirm the subtype; in 2016, the same population was followed up, and the HIV subtype variation was analyzed, and the influencing factors of subtype variation were explored by multivariate logistic regression. Results:A total of 612 HIV/AIDS cases in 2014 and 2016 were collected. The age of the subjects was mainly 30 years old or above (85.46%, 523/612), and the proportion of people over 50 years old was higher (228/612, 37.25%). The main route of transmission was homosexuality, accounting for 49.67%. A total of 1224 samples were detected and CRF01 _ AE、CRF07_ BC、B、CRF08_ BC、CRF67_ 01B、CRF55_ 01B、CRF68_ 01B, 7 subtypes of HIV-1 and 5 unique recombinant types (URFs) was detected. CRF01_ AE and CRF07_ BC was still the main genotype in Wuxi, Jiangsu Province, accounting for 66.75%. There were 29 cases (3.56%) of URFs recombinant strains. During 2014-2016, the variation rate of subtypes was 14.63%, and the most common variation was CRF01_ AE changes to CRF07_ BC(13.95%). Marital status (OR=0.363, 95% CI: 0.137-0.964) and baseline CD4 level (OR=0.414, 95% CI: 0.192-0.891) were associated with subtype variation.Conclusions:The HIV-1 subtypes of HIV/AIDS patients in Wuxi city are diverse and complex, the proportion of recombinant subtypes is rising, the URFs that are difficult to determine the genotype increase significantly, and the variation rate of HIV-1 subtypes among HIV/AIDS infected people is high. It is necessary to strengthen the monitoring of HIV-1 subtypes.

[Objective]To explore the health preservation thoughts contained in Three Essentials of Health Cultivation written by the health practitioner YUAN Huang in Ming Dynasty,providing certain techniques for modern people to cultivate and maintain health.[Methods]By using literature research methods,this paper analyzes the health preservation content of Three Essentials of Health Cultivation and systematically interprets it in conjunction with classic theories of traditional Chinese medicine(TCM)and traditional Chinese culture.By adopting the approach of"passing on the ancient culture without adding anything new to it",the paper delves into the health preservation ideas and methods contained in the book,analyzes the author's contribution to health preservation and the guiding significance of health preservation benefits for people in today's society.[Results]The Three Essentials of Health Cultivation was written by YUAN Huang,who was a native of Jiashan Zhejiang during the Ming Dynasty.This book was extracted by later generations from the YUAN Huang's True Interpretation of Praying for Inheritance.In the book,YUAN Huang elaborated the three major principles of maintaining health:essence,Qi and spirit,namely gathering essence,nourishing Qi and preserving spirit for health preservation.The book contains both the health preservation concepts of TCM and the techniques of Taoism and Buddhism.Its health preservation techniques are friendly and natural which are explained reasonably,making it particularly practical.[Conclusion]The health preservation methods mentioned by YUAN Huang are simple and practical,which are easy to understand and practice for modern people who are obsessed with external factors and have rare leisure time.If one can practice a little while busy,he can achieve the goal of maintaining physical and mental health and promoting a better life.

Objective To evaluate the changes in anterior chamber structure of pelvic floor before and after total hysterectomy with transperineal ultrasonography.Methods Forty-five patients who would receive total hysterectomy were enrolled.The structures of the anterior pelvic floor were observed with transperineal ultrasonography 1 day pre-operation and 1,3 and 6 months after operation.The parameters at rest and max Valsalva were recorded and calculated,including the bladder neck-symphyseal distance (BSD),bladder neck descent (BND),urethral rotation angle (UR) and posterior urethrovesical angle (PUA).The changes of the parameters at different time were analyzed statistically.Results BSD at max Valsalva,BND,UR and PUA at max Valsalva at different time were significantly different (all P＜0.05).Compared with those preoperative,BSD at max Valsalva decreased (H=2.627,P=0.009) and BND increased (q=-3.095,P=0.002) 3 months after operation,BSD at max Valsalva decreased (H=4.379,P＜0.001),BND (q=-4.379,P＜ 0.001),UR (H=-2.861,P=0.004) and PUA at max Valsalva (q=-2.686,P=0.007) increased 6 months after operation.The remaining parameters were not significantly different between every two time points (all P ＞ 0.05).Conclusion The changes of BSD,BND at max Valsalva,UR and PUA at max Valsalva occur at the initial period after the total hysterectomy.The total hysterectomy can damage the pelvic floor and early pelvic floor rehabilitation need to he provided.

Objective To observe the surface area temperature of dysmenorrhea rats with cold stagnation syndrome; To compare the different effects of Sanyinjiao (SP6) and Guanyuan (RN4).Methods Forty female SD rats were randomized into control group, model group, Sanyinjiao (SP6) group, and Guanyuan (RN4) group, 12 rats in each group. Whole body freezing method combined with estradiol benzoate injection was used to establish models. Sanyinjiao (SP6) group and Guanyuan (RN4) group received moxibustion at corresponding points for 3 times after modeling. Infrared thermal imaging was used to measure the skin temperature at the surface projection area of Sanyinjiao (SP6) and Xuehai (SP10) and Sanyinjiao-Xuehai lines before and after moxibustion.Results Compared with control group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly increased in model group 5-30 min after moxibustion (P<0.05). 30 min after moxibustion, the temperature of right Sanyinjiao significantly decreased in other three groups (P<0.01). Compared with model group, the temperature gap between double sides of Sanyinjiao-Xuehai lines significantly decreased after 5-30 min in Sanyinjiao group (P<0.05), while Sanyinjiao-Xuehai lines significantly decreased after 10-30 min in Guanyuan group (P<0.05). Comparison between two moxibustion groups, the influence of Sanyinjiao group to temperature gap between double sides of Sanyinjiao-Xuehai lines was earlier than Guanyuan group (P<0.05).Conclusion Moxbustion can decrease the temperature gap between double sides of Sanyinjiao-Xuehai lines and ease the imbalance. And the influence of moxbustion SP6 to temperature gap between double sides of Sanyinjiao-Xuehai lines is earlier than moxibustion RN4.

Objective To investigate the clinical effectiveness of the reversed flaps pedicled with lateral vas-cular chain of dorsal branch of digital artery and perforating branch of the dorsal metacarpal artery for relaying repair of soft tissue defects at middle-distal part of the 2nd ～ 5th finger and donor site. Methods From June, 2014 to May, 2016, a total of 18 cases (11 male and 7 female) with soft tissue defects at middle-distal part of 2nd～5th fin-ger were treated with the reversed flap pedicled with lateral vascular chain of dorsal branch of digital artery. The donor site was repaired with the reversed flap pedicled with the perforating branch of the dorsal metacarpal artery. The aver-age age at the time of reconstruction was 41 years. The right hand was involved in 12 cases and the left in 6 cases. The etiologies of injury were avulsion (n=5) , crush (n=6), and saw-cut injury (n=7). There were 15 cases with soft tissue defect at the distal phalanx and 3 cases with loss of distal and middle phalanx. All these cases were exposed with bone or tendon. The defect size ranged from 1.0 cm × 1.8 cm to 2.0 cm × 3.0 cm. And the dimension of the re-versed flaps pedicled with lateral vascular chain of dorsal branch of digital artery and perforating branch of the dorsal metacarpal artery ranged from 1.2 cm × 2.0 cm to 2.3 cm × 3.3 cm, and 1.4 cm × 2.3 cm to 2.6 cm × 3.6 cm, respec-tively. Postoperative follow-up was done termly. Results All flaps survived uneventfully with primary healing at donor site. The mean of followed-up time was 11 months (ranged from 6 to 15 months). The appearance and texture of the flaps were satisfactory and similar to the surrounding tissue. There was only some linear scar left at the dorsum of the palm. On the basis of the MHQ, 16 patients were strongly satisfied (score 5) with the appearance of the flap, and the remaining 2 patients was satisfied (score 4) with the appearance. The static 2-point discrimination of the flaps at the middle-distal part of 2nd～5th finger was 5-9 mm. Based on TAM assessment, the function of the injured finger was graded as excellent in 15 cases, good in 3 cases. Conclusion The relaying reversed flaps pedicled with lat-eral vascular chain of dorsal branch of digital artery and perforating branch of the dorsal metacarpal artery can be applied for repair of soft tissue defects at middle-distal part of 2nd～5th finger and donor site with easy procedure, reliable blood supply, satisfactory results, good appearance as well as less complications at donor sites.