Objective To contrast the accuracy rate of nuclear magnetic resonance imaging (MRI)-staging and the International Federation of Gynecology and Obstetrics (FIGO, 2009) clinical-staging, and evaluate the value of MRI in diagnosis of lymph node metastasis in cervical cancer. Methods The surgical pathology was used as golden standard, the accuracy rates of MRI-staging and FIGO-staging were compared in 86 patients of cervical cancer (surgical pathological staging≥Ⅰb). The lymph nodes with slightly hyperintense signal in diffusion-weighted magnetic resonance imaging (DWI) and with minor axis≥1 cm in T2WI-TRA (T2 weighted imaging-transverse section) were considered as metastatic lymph nodes, the characteristics of lymphatic metastasis diagnosed by MRI were analyzed, and the accuracy rate, the sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI were evaluated. Results The accuracy rate of FIGO-staging was 80.2%(69/86), and the accuracy rate of MRI-staging was 83.7%(72/86), there was no significant difference between them (P > 0.05). The accuracy rate of lymphatic metastasis diagnosed by MRI was 94.2%(81/86), the sensitivity was 73.3%(11/15), the specificity was 98.6%(70/71), the positive predictive value was 91.7%(11/12), and the negative predictive value was 94.6%(70/74). The true positive metastatic lymph nodes in 11 cases were located in the external iliac nodes or common iliac lymph nodes, the average short/long diameter was 0.76. The forms of lymph nodes were as follows:quasi-circular (n=3), border irregularity (n=3), huge fusion form (n=4), and 1 with central necrosis area. One case of false positive metastatic lymph node was located in the right external iliac node, with the sharp of huge fusion form in T2WI/TRA, comminution in T2WI-axial thin slices, and long strip in T2WI/SAG. Conclusion The accuracy rates of MRI-staging and FIGO-staging were both higher, which can diagnose lymphatic metastasis relatively accurately when they are combined together.

OBJECTIVETo study the influence of nasolabial angle alteration on facial profile attractiveness and investigate the perception differences in profile attractiveness among laypeople.

METHODSA young Chinese female with normal hard and soft tissue cephalometric values was chosen as a research object. Profile photograph was taken in a natural head position. Photoshop software was chosen to rotate the nose tip and upper lip, thus changing the degree and direction of nasolabial angle. A total of 33 different profile pictures were achieved. Thirty-three professional orthodontists and 64 non-professionals were chosen to score these 33 pictures.

RESULTSWhen the upper lip position was fixed, the profile was considerably attractive because the angle of nasal tip was not changed or altered. When the nasal tip rotation angle was fixed, profiles with a retroclined upper lip were considered significantly attractive by the layperson and professional groups. Regardless of the direction of the nasal tip rotation, the respondents considered the profile with a retroclined upper lip highly attractive.

CONCLUSIONThe soft tissue profile with a retroclined upper lip looks considerably attractive in Chinese female populations. Therefore, during an orthodontic treatment, appropriate retraction of the incisor is recommended to improve soft tissue profile attractiveness.

Cephalometry ; Esthetics ; Face ; anatomy & histology ; Female ; Humans ; Incisor ; Lip ; Nose

Objective To analyse the multi-slice spiral CT(MSCT) findings of small cholangiocarcinoma of common bile duct.Methods 15 cases with pathologically verified small cholangiocarcinoma of common bile duct were undergone unenhanced and three-phase contrast-enhanced MSCT scan.The entire morphologic changes of common bile duct were analysed with curved planar reformation(CPR).Results The attenuation of tumor relative to pancreas was iso-density in all cases at plain CT scan,hypo-density in 10 cases,iso-density in 3 cases and hyper-density in 2 cases at arterial phase,hypo-density in 1 case,iso-density in 3 cases and hyper-density in 11 cases at portal phase,iso-density in 5 caaes and hyper-density in 10 cases at delayed phase.The focal wall thickening of common bile duct appeared as circular or eccentric in 13 cases,intraluminal nodule in 2 cases,common bile duct was narrowing sharply in 11 cases and ending abruptly in 4 cases at obstructive level.Conclusion The small cholangiocarcinoma of common bile duct is of certain characteristics at unenhanced and three-phase contrast-enhanced CT scan.

Objective To explore the diagnostic value of MR fast imaging sequences in fetal lung congenital cystic adenomatoid malformation(CCAM).Methods 8 cases with suspected CCAM by US were examined with MRI fast sequences,including single shot turbo spin echo (SSTSE)and balanced fast field echo(B-FFE),and undergone axial,sagital and coronal scanning sections of fetal chests.MRI findings were compared with surgery(2 fetuses),autopsy (3 fetuses)and CT examination (3 fetuses).Results 7 fetuses with CCAM and 1 fetus with bronchopulmonary sequestration(BPS)diagnosed by MRI were confirmed by following surgery,autopsy and CT examination.Among the 7 CCAM cases,2 leisions were on the left side,while the other 5 lesions were on the right side.Fur-thermore,2 cases were cystic type and the rest 5 cases were mass type.The BPS was located in the lower left lung lobar.Conclusion MR fast imaging sequences in fetal can clearly demonstrate location,type and extent of CCAM and can provide important supplement information of the prenatal fetal ultrasound examination.

AIM To investigate the effects of trifluoperazine on naloxone precipitated withdrawal symptoms in morphine dependent rats and mice, and its pharmacological mechanisms. METHODS\ Naloxone precipitated tests in morphine dependent rats and mice were used. RESULTS\ Trifluoperazine(2～20 mg?kg -1 ) dose dependently inhibited naloxone precipitated withdrawal jumping, wet dog shakes, paw tremor and weight loss in morphine dependent mice. With ip trifluoperazine (5～20 mg?kg -1 ), most of positive withdrawal symptoms, including jumping, wet dog shakes, defeacation, weight loss, teeth chattering, salivation, diarrhea, ptosis and irritating, induced by naloxone in morphine dependent rats were significantly reduced. Apomorphine (2～8 mg?kg -1 ), a mixed DA 1/DA 2 receptor agonist, did not affect inhibition of trifluoperazine on naloxone precipitated withdrawal symptoms in morphine dependent mice. However, nifedipine(5～20 mg?kg -1 ), a L type voltage sensitive calcium channel blocker, enhanced a pharmacological action of trifluoperazine against naloxone precipitated symptoms in morphine dependent mice. CONCLUSION\ Trifluoperazine attenuates naloxone precipitated withdrawal symptoms in morphine dependent rats and mice by inhibiting the activity of post receptor calmodulin, but it does not antagonizes DA 2 receptor, in central nervous system.

Objective To investigate the value of MRI in the prenatal diagnosis of abnormal fetal kidneys. Methods From December 2014 to March 2016, 51 women underwent MRI and were confirmed as having fetuses with abnormal fetal kidneys when follow up. Their clinical and MRI profiles were analyzed retrospectively, including MRI manifestation, the fetal kidney signal intensity of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC). The signal intensity of DWI and ADC of the abnormal kidney and the normal opposite kidney, and those of the normal and abnormal kidneys in different individuals were compared. The accuracies of MRI and ultrasound in evaluating abnormal fetal kidneys were also compared. Results MRI could accurately demonstrate the morphological features of abnormal fetal kidneys. There was no statistically significant difference between DWI signal intensity and ADC value of the abnormal kidney[368 ± 125,(1.516 ± 0.420)× 10-3 mm2/s] and the normal opposite one[410 ± 125,(1.362 ± 0.251)× 10-3 mm2/s], P values were 0.165 and 0.184,respectively. The DWI signal intensity of normal kidneys(401 ± 124)was higher than that of renal cysts(182 ± 40, P<0.01), and the ADC value of normal kidneys[(1.306 ± 0.252)× 10-3 mm2/s] was lower than that of renal cysts[(2.912 ± 0.235)× 10-3 mm2/s] and multicystic dysplastic kidneys[(1.870 ± 0.654)× 10-3 mm2/s], P values were<0.01 and 0.045, respectively. The diagnostic accuracy of MRI and prenatal ultrasound for abnormal fetal kidneys were 94%(63/67)and 85%(57/67), respectively. However, there was no statistical difference between the two methods (P=0.070). Conclusion MRI have an important role in the prenatal diagnosis and evaluation of abnormal fetal kidneys.

Objective To investigate the effects and the mechanism of thrombospondin 4 (Thbs4) gene-edited bone marrow mesenchymal stem cells (BMSCs) transplantation on vascular endothelial growth factor (VEGF) and angiopoietin-1 (Ang-1) in diabetic rats with hind limb ischemia. Methods Thirty Sprague-Dawley rats were randomly divided into the model group, BMSCs treatment group and Thbs4-BMSCs treatment group on average. After constructing the typeⅡdiabetic rat model with hind limb ischemia, 100μl normal saline, BMSCs suspension and Thbs4-BMSCs suspension (cell number: 2×106) were locally injected into the ischemic injury area of rats for the model group, BMSCs group and Thbs4-BMSCs group, respectively. The rats were sacrificed on the 14th day after stem cell transplantation, and the muscle tissues near the ischemic area were collected. The relative expression of VEGF and p-Smad2/3 protein was detected by Western Blot. The Ang-1 protein expression was detected by immunofluorescence staining. The levels of related genes were detected by qRT-PCR, and the von Willebrand Factor (vWF) protein expression was detected by immunohistochemistry staining. Results The relative expression levels of VEGF, Ang-1 and vWF protein in the Thbs4-BMSCs group were significantly higher than those in the model group and BMSCs group (VEGF protein:P<0.01 and P<0.05). The mRNA expression of VEGF and Ang-1 were significantly up-regulated, the differences were statistically significant(VEGF mRNA:all P<0.01;Ang-1:P<0.01 and P<0.05). The expression of p-Smad2/3 protein in the Thbs4-BMSCs group was significantly higher than that in the model group and the BMSCs treatment group (all P<0.01). The expression of p-Smad2/3 protein was significantly decreased after the addition of p-Smad2/3 pathway inhibitor, the differences were statistically significant (P<0.05). Conclusions Thbs4-BMSCs transplantation can effectively promote angiogenesis in diabetic rats with hind limb ischemia, and the effect of angiogenesis may be related to the activation of Smad2/3 signaling pathway.

OBJECTIVETo explore the efficacy of unrelated umbilical cord blood transplantation (UCBT) in the treatment of Gaucher disease.

METHODThe clinical characteristics of three children with Gaucher disease underwent UCBT in our hospital between April 2013 and September 2014 were retrospectively analyzed. Literature on allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of Gaucher disease was searched at Wanfang and Pubmed databases between 1983 and 2015 and was reviewed and summaried.

RESULTThree children with Gaucher disease, all were female, received UCBT. These patients' age at receiving transplantation was 3.8 years, 7.1 years and 2.6 years, respectively. The second case received the second transplantation. The first and third case received splenectomy before UCBT. The pretreatment regimen was busulfan (Bu)/fludarabine (Flu)/cyclophosphamide (CTX)/antithymocyte globulin (ATG), and for the patient received the second transplantation melphalan was added to the myeloablative conditioning regimen of Bu/Flu/CTX/ATG. Cyclosporine and mycophenolate mofetil (MMF) wee used for prophylaxis of acute graft versus host disease (aGVHD). The dose of cord blood stem cell nucleated cell counts was 9.7 × 10⁷ /kg,11.9 × 10⁷ /kg and 7.6 × 10⁷/kg respectively. The dose of cord blood stem cell CD34⁺ cell counts was 5.4 × 10⁵/kg , 3.5 × 10⁵/kg and 3.2 × 10⁵/kg respectively. The day of granulocytes exceeding 0.5 × 10⁹/L was day 11, 12 and 19 after transplantation, respectively. The day of platelets exceeding 20 × 10⁹/L was day 14, 33 and 74 after transplantation, respectively. At one month after transplantation the rate of chimerism was over 95% and all patients got donor complete chimerism. The level of β-glucocerebrosidase recovered to normal at one month after transplantation. During transplantation, all patients developed cytomegalovirus (CMV) and Epstein-Barr virus (EBV) viremia. In case 1 immune thrombocytopenia occurred at five month after transplantation unresponding to steroids and mesenchymal stem cells infusion was administered and his platelet in routine blood test recovered to normal. But the patient died because she was infected with varicella-zoster virus out of hospital at nine month after transplantation and the level of β-glucocerebrosidase was normal before death and chronic GVHD (cGVHD) was not found. The case 2 is now in 19th month after transplantation and his level of β-glucocerebrosidase was normal. cGVHD was not found. The patient is currently free of disease. The case 3 was in 9th month after transplantation and his level of β-glucocerebrosidase was normal. cGVHD was found at 112 day after transplantation and was localized and could be controlled by hormonal therapy. The patient is currently free of disease. Three patients' size of liver was significantly reduced after their level of β-glucocerebrosidase ecovered. There were 50 cases with Gaucher disease who were treated with allo-HSCT in the literature and none of them were reported from China. Disease-free survival rate of patients treated with allo-HSCT for Gaucher disease was 85%. In all reports, there were 31 cases who had information of typing of Gaucher disease, of whom 22 cases had type 1 and 9 cases had type 3. Twenty-nine cases had information of survival, of whom 24 cases survived and 5 cases died of infection. Fifteen cases had data of engraftment, 2 of whom had graft failure and one had late graft failure.Glucocerebrosidase recovered to normal in 25 of 31 cases who had relevant data, in one of whom with late graft failure the enzyme recovered to normal 3 month after transplantation, but his enzyme decreased to the initial level 9 month after transplantation. Along with enzyme level's recovery to normal, in a part of cases bone pain and hepatomegaly were relieved and growth delay was improved.

CONCLUSIONThe unrelated UCBT may be a form of treatment that offers the potential of permanent cure and a procedure with possible long-term benefits in patients with Gaucher disease.

Antilymphocyte Serum ; therapeutic use ; Busulfan ; therapeutic use ; Child ; Child, Preschool ; China ; Cyclophosphamide ; therapeutic use ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Female ; Gaucher Disease ; therapy ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Retrospective Studies ; Transplantation Conditioning ; Vidarabine ; analogs & derivatives ; therapeutic use

OBJECTIVE: To explore the influence of hypoxemia on the hearing of children with childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: Auditory brainstem response (ABR) and distortion-product otoacoustic emission (DPOAE) was recorded in 68 ears and 60 ears respectively of children suffering from OSAHS with "A" tympanogram. Meanwhile, ABR and DPOAE was also recorded in 30 controls of children with "A" tympanogram. RESULT: There was no statistical difference between the mild OSAHS group and the control group in the latency of wave I, III and V, the interval between wave I and III, III and V, I and V. There was significant difference between the moderate and severe OSAHS group and the control group in the delayed latency of wave I. There was significant difference between the mild OSAHS group and the control group in the amplitudes of DPOAE at 8 kHz. There was significant difference between the moderate and severe OSAHS group and the control group in the amplitudes of DPOAE at 6 kHz and 8 kHz. CONCLUSION Cochlear function was affected when AHI > or = 10/h. ABR and DPOAE could be used to detect the early damagement of auditory function in childhood OSAHS.
Adolescent ; Child ; Child, Preschool ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Otoacoustic Emissions, Spontaneous ; Sleep Apnea, Obstructive ; physiopathology

OBJECTIVE: To investigate the characteristic of nystagmus and treatment of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). METHOD: The positioning nystagmic features in 43 patients with HSC-BPPV treated between April 2004 and October 2006 were recorded and analyzed with video nystagmography. After the subtype and the effect side were determined, the appropriate repositioning maneuvers were chosen. RESULT: (1) Geotropic nystagmus was recorded in 27 cases, of whom 19 cases were treated with barbecue maneuver and/or combined forced prolonged position maneuver, while the others were treated with Asprella's maneuver. (2) Apogeotropic nystagmus was recorded in 16 cases with two types, one of which could turn into geotropic nystagmus with Gufoni's maneuver or spontaneously (in 12 cases), the other type could not (in 4 cases) transform accepted barbecue maneuver and/or combined forced prolonged position maneuver. The total improvement rate was 72.1% after 1 week and 81.4% 3 months later respectively. CONCLUSION The otolith position and the pathogenesis could be distinguished according to the nystagmic characteristics and type of HSC-BPPV. It was necessary to apply the appropriate repositioning maneuvers to treat HSC-BPPV.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Nystagmus, Pathologic ; therapy ; Semicircular Canals ; Treatment Outcome ; Vertigo ; diagnosis ; therapy