Objective To explore the morphologic features of the biceps reflection pulley through the comparative study of the thin sec -tional anatomy based on the Chinese Visible Human ( CVH) and MRI sectional anatomy of the biceps reflection pulley ,and to provide ima-ging anatomic data for the diagnosis of lesions .Methods The thin slices of sagittal oblique plane and coronal oblique plane by visualization -al reconstruction based on 5 data set of the Chinese visible human ( CVH) were compared with the corresponding MR images from 20 shoulder joints of the normal volunteer individuals with routine MRI ,5 shoulders without abnormalities with MR arthrography .The detailed sectional a-natomy structure of the the biceps reflection pulley was marked from the CVH ,routine MRI and MR arthrography one by one with Photoshop CS2 software.Results The main three components of the biceps reflection pulley including the coracohumeral ligament (CHL),the superior glenohumeral ligament ( SGHL) ,and the long head of the biceps tendon ( LBT) were markedly displayed on the CVH and MRI .The CHL was markedly displayed on the sagittal oblique , using plain MRI .The SGHL was markedly displayed on the CVH , especially in the transverse plane.The LBT was markedly displayed on the CVH ,especially in the coronal oblique plane parallel to the LBT .The biceps reflection pulley was markedly displayed on the sagittal oblique plane with CVH and MR arthrography .The SGHL was perpendicular to the CHL , with T-shaped link anterior to the LBT on the sagittal oblique plane .Conclusion It is complementary for MRI and CVH displaying the components of the biceps reflection pulley .The sagittal oblique plane is the best position for displaying the components and adjacent structures of the bi -ceps reflection pulley ,which provide helpful position mark for the diagnosis of the lesions in the rotator interval .

Objective To investigate the effect of Tangshan earthquake stress on the executive and memory func?tion in adults. Methods The objects were recruited from Tangshan Kailuan Mining Group. The exposed group included 251 subjects whose mothers exposed to the Tangshan earthquake during pregnancy in 1976. The control group included 341 subjects whose mothers was pregnant the year after the Tangshan earthquake. According to mother's pregnancy time relative to the earthquake exposed group was divided into 3 subgroups:the late pregnancy of earthquake exposed group, the second trimester of earthquake exposed group and the early pregnancy of earthquake exposed group. Wisconsin Card Sorting Test (WCST) was used to evaluate executive function, Brief Visuospatial Memory Test-Revised (BVMT-R) was used to evaluate memory function. Results The index of WCST were not different between two groups (P>0.05). Com?pared with control group, BVMT-R total scores were lower in earthquake exposed group [(25.54 ± 7.45) vs. (27.28 ± 7.10), P<0.01]. In the earthquake exposed group, pregnancy and sex had interaction effect on the nonpreservative errors (nRpe) of WCST (P<0.05). In the late pregnancy earthquake exposed group, male had higher nRpe than female (P<0.01). Preg?nancy time had main effect on offsprings' BVMT-R scores (P<0.05). The BVMT-R total scores were lower in late trimes?ter pregnancy and in second trimester pregnancy than in the early pregnancy (P<0.05). Conclusion The Tangshan earth?quake has potential effect on the memory function of the offsprings. The second trimester (4-to 6-month) and the third trimester (7-to 9-month) may be the sensitive pregnancy window of the stress during the pregnancy. The male offspring from late pregnancy of exposed earthquake have poorer executive function than female.

Objective To evaluate the diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane with MRI.Methods There were 60 patients(120 shoulder joints)in control group,with 30 males and 30 females,the mean age was 50.5 years old.There were 72 shoulder joints in 72 patients of frozen shoulder group(50 femles and 22 males with a mean age of 53.5 years)with clini-cal evidence and MR imaging evidence of frozen shoulder.These were prospectively analyzed to identify the CHL visualization rate and meas-ure the maximum thickness of the CHL.Results The CHL visualization rate on the coronal oblique plane in the control group was 86.7%(104 /120),and the frozen shoulder group was 87.5%(63 /72),the difference was not significant(P >0.05).The CHL visualization rate on the axial view in the frozen shoulder group was 19.4%(14 /72)and the control group was 24.2%(29 /120),the difference was not signifi-cant(P >0.05).The CHL thickness on the coronal oblique plane (n =63)in the patients with frozen shoulder was (4.37 ±1.71)mm, which was significantly greater than (2.84 ±0.79)mm ofpatients in the control group(n =104),the difference was significant(P <0.001). The CHL thickness on the axial plane(n =14)in the patients with frozen shoulder was (3.93 ±1.49)mm,which was significantly greater than (2.29 ±0.65)mm of patients in the control group(n =29),the difference was significant(P <0.001).Conclusion A thickened CHL is highly suggestive of frozen shoulder,which is 4.37 mm on the coronal oblique plane.

Objective To study the values of change of diameter (ΔD%)on DCE-MRI and ΔD% combined with ADC for the therapeutic effect evaluation in the neoadjuvant chemotherapy(NAC)of each subtype of breast cancer.Methods 121 women with invasive breast cancer were enrolled in this study,including 56 cases of Luminal A type,42 cases of Luminal B type,13 cases of Her-2 type and 10 cases of triple negative type.Results Imaging evaluation results obtained by single applying DCE-MRI was analyzed with the pathological results after surgery for the consistency,and the Kappa values of Luminal A,Luminal B,Her-2 and triple negative type were 0.594,0.617,0.401,0.690,0.800,respectively.When combining ΔD% with ΔADC%,the Kappa values were 0.844,0.792,0.854, 0.847 and 0.800,respectively.The sensitivity of combined parameters in evaluating pCR after NAC was significantly increased in Luminal type cancers,however,with a slightly increasing in Her-2 type,and constant in triple negative type.Conclusion ΔD% combining with ΔADC% is better than single parameter in evaluating pCR for Luminal and Her-2 types cancer,but not for triple negative type.

Objective:To investigate the early warning value of transcutaneous oxygen pressure and transcutaneous carbon dioxide pressure (TcPO 2/TcPCO 2) monitoring in patients with pressure injury in ICU. Methods:A prospective clinical observation study was conducted. Patients were selected in the department of critical care medicine of Shenzhen Hospital Affiliated to University of Chinese Academy of Sciences from December 2020 to June 2022. The general information of all patients were recorded. The data of TcPO 2 and TcPCO 2 were monitored respectively in left lying position, supine position and right lying position. According to the Braden score of patients, they were divided into low risk group and high risk group, and the monitoring results of TcPO 2/TcPCO 2 were analyzed. Results:The study included a total of 80 patients, with 46 patients in the low risk group and 34 patients in the high risk group. There were no significant differences in gender and age between the two groups (both P>0.05). There were significant differences in the Braden score and the incidence of pressure injury between the two groups (both P<0.05). There were statistically significant differences in TcPO 2 at various time points in the left lying position, supine position and right lying position between the low risk and the high risk groups (all P<0.001). Except for the 15th minute of the left lying position and right lying position, there were statistically significant differences in TcPCO2 at all other time points in the supine and right lying positions between two groups (all P<0.05). There were statistically significant differences in TcPO 2/TcPCO 2 values at various time points in different positions between two groups (all P<0.001). In supine position, TcPO 2 and TcPO 2/TcPCO 2 were positively correlated with the Braden score ( r=0.680, 0.741). TcPCO 2 was negatively correlated with the Braden score ( r=-0.771). The Braden score, TcPO 2, TcPCO 2 and TcPO 2/TcPCO 2 all have moderate diagnostic value. The cut-off values were 12.50, 41.48 mmHg, 52.29 mmHg and 0.91, respectively. And the AUC were 0.899, 0.727, 0.816 and 0.719, respectively. However, there were no significant differences in AUC between the TcPO 2, TcPCO 2, TcPO 2/TcPCO 2 and Braden score (all P>0.05). Conclusions:TcPO 2, TcPCO 2 and TcPO 2/TcPCO 2 values all have higher diagnostic value about pressure injury for patients in ICU. TcPO 2/TcPCO 2 monitoring has early risk warning value for the occurrence of pressure injury in ICU, which is worthy of clinical promotion.

Objective To compare the short-term clinical effects of unilateral dual-channel endoscopic discectomy(UBED)and percutaneous endoscopic intervertebral discectomy(PEID)in the treatment of L5S,Lumbar disc herniation,LDH.Methods From January 2019 to January 2021,a total of 57 cases of L5S,LDH treated by UBED or PEID were analyzed retrospectively,including 30 cases in UBED group and 27 cases in PEID group.The operation time,intraoperative fluoroscopy times,postoperative hospitalization days and surgical complications were compared between the two groups.The visual analogue scale(VAS)and oswestry disability index(ODI)were used to compare the postoperative quality of life of the two groups,and the modified MacNab criteria was used to evaluate the clinical efficacy in the last follow-up.Results The operation time of UBED group and PEID group was(75.30±8.44)minutes and(68.37±4.63)minutes,respectively,and the difference between the two groups was statistically significant(P＜0.05).VAS and ODI of 1 week,3 months,1 year and 1.5 years after surgery in 2 groups were significantly decreased compared with those before surgery,with statistical significance(P＜0.05).The VAS score of low back pain in UBED group was higher than that in PEID group[(3.87±1.14)points vs(2.70±0.67)points]at 1 week after surgery(P＜0.05),and there was no significant difference in VAS and ODI at the other time points(P＞0.05).There was no statistical difference in the results of modified MacNab criteria in the last follow-up(P＞0.05).There were 2 cases of dural tear in PEID group,1 case of dural tear in UBED group and 1 case of temporary nerve root injury in PEID group after operation,all of which were cured after symptomatic treatment.Conclusion Compared with PEID,UBED has a longer operation time,more trauma and more obvious low back pain in the short term after operation.The short-term curative effect of the two operations on L5S1 LDH is similar,the incidence of complications is low,and the times of fluoroscopy are few.Both operations are safe and effective.

Adolescent ; Adult ; Aged ; Carcinoma in Situ ; surgery ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Vulvar Neoplasms ; surgery

Objective To explore association between childhood trauma,resilience and non-suicidal self-injury in adolescents.Methods One hundred and fifty-eight first-episode adolescent patients with mood disorders were selected and divided into NSSI group(n=94)and non-NSSI group(n=64)based on presence or absence of NSSI.The Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),childhood trauma questionnaire(CTQ-SF)and Connor-Davidson resilience scale(CD-RISC)were used to evaluate the depression and anxiety symptoms,childhood trauma and resilience.Results There were more cases of younger age(16.17±1.67 vs.16.73±1.37),lower education level(30.9% vs.15.6% ),left behind experience(48.9% vs.29.7% ),school bullying(46.8% vs.25.0% ),suicide ideation(85.1% vs.37.5% )and history of attempted suicide(29.8% vs.6.3% )in the group with NSSI compared to those without NSSI.The HAMD score(27.99±5.94 vs.24.19±5.19),HAMA score(18.02±5.94 vs.15.45±4.99),CTQ total score(48.43±15.40 vs.41.97±9.75),emotional abuse score(12.77±6.06 vs.10.19±4.06),and emotional neglect score(11.40±5.34 vs.9.14±3.55)were higher in the group with NSSI,and the differences between the two groups were significant(P<0.05).The total scores of psychological resilience(39.83±10.27 vs.28.66±12.75),resilience(19.59±4.92 vs.12.28±6.47),strength(12.03±3.98 vs.9.99±4.67),and optimism(8.98±2.97 vs.6.47±3.73)in the group without NSSI were higher than those in the group with NSSI(P<0.05).Logistic regression analysis showed that left behind experience(OR=4.494,95% CI:1.192-16.940),school bullying(OR=5.983,95% CI:1.329-26.945),suicidal ideation(OR=13.225,95% CI:2.908-60.146),history of attempted suicide(OR=16.769,95% CI:1.845-152.379),HAMD(OR=1.264,95% CI:1.046-1.626),emotional abuse(OR=1.327,95% CI:1.093-1.612),and resilience(OR=0.468,95% CI:0.266-0.823)were significantly associated with adolescent mood disorders with NSSI(P<0.05).Conclusion Left behind experience,campus bullying,suicidal ideation and attempted suicide,emotional abuse,degree of depression,and psychological resilience may be associated with NSSI behavior in adolescents with mood disorders.

Objective: To explore the impact of immediate breast reconstruction on the onset of adjuvant chemotherapy and on the postoperative complications. Methods: We retrospectively analyzed the clinical data from female breast cancer patients treated by either modified radical mastectomy with immediate breast reconstruction(IBR) ( n=108) or modified radical mastectomy alone(n=115), followed by adjuvant chemotherapy at our department between January 2011 and December 2012. Results: There was no significant difference in the overall complication rates between the IBR group and modified radical mastectomy group (49.1% vs. 52.2%, P=0.87). However, more secondary surgery was applied in the IBR group than the modified radical mastectomy group (13.0% vs. 1.7%, P=0.001). However, the incidence of hematoma in the modified radical mastectomy group was significantly higher than the IBR group (17.4% vs. 4.6%, P=0.003). There was a significant difference in the onset of adjuvant chemotherapy between the IBR group and modified radical mastectomy group (21 days vs. 11days, P<0.001). Conclusions Immediate breast reconstruction has no significant impact on the overall complication rate, but increases the incidence of secondary surgery, especially after the initiation of chemotherapy. In addition, it slightly delays adjuvant chemotherapy in the patients.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*