Objective To investigate the hemostatic effect of balloon compression on the puncture site in cancer patients with peripherally inserted central catheter (PICC) inserted by ultrasound-guided modified Seldinger technique (MST). Methods Between October 2015 to January 2016, 50 cancer patients who accepted PICC inserted by ultrasound-guided MST were assigned into test group and control group respectively according to the admission time.Each group contained 25 cases. Balloon compression method was used to stop bleeding of the puncture point in the test group, while bandage compression hemostasis adopted in the control group. Results The incidence of bleeding on puncture site in the last 24 h of PICC placement was 28% (7/25) in the test group, while 68% (17/25) in the control group, and there were statistical differences between the groups (Z=-2.653,P<0.01). The incidence of bleeding on puncture site in 24-72 h of PICC placement was 16% (4/25) in the test group, while 36% (9/25) in the control group, and the difference had statistical significance (Z=-1.679,P>0.05). The incidence of limb swelling or numbness in the test group was 8% (2/25),which was lower than 32% (8/25) in the control group, and the difference had statistical significance (χ2=4.5,P < 0.05). Conclusions Balloon compression method can reduce the bleeding ratio of puncture site in cancer patients with PICC inserted by ultrasound-guided MST,and can relieve limb swelling or numbness .It is simple and safe in operation and can be easily accepted by the patients .

Objective To analyze MRI and MRCP appearances of duodenal papilla adenocarcinoma with low biliary obstruction,in order to improve the diagnosis of this lesion.Methods The clinical data of 29 patients with duodenal papilla adenocarcinoma con-firmed by pathology were retrospectively analyzed.All cases were scanned by un-enhanced MR and MRCP,and the lesion shape,sig-nal characteristics and biliary obstruction of the lesion were analyzed.Results A soft tissue mass or nodule in the duodenal papilla region was showed in 29 cases.On non-enhanced T1 WI,1 9 lesions demonstrated slightly hypointense ,10 lesions were isointensity. On T2 WI,21 lesions were slightly hyperintense,8 lesions were isointensity.On DWI(b=800 s/mm2 ),the lesions were hyperintense or slightly hyperintense.On MRCP,the narrow at the distant end of the common bile duct was showed;20 lesions showed the expan-sion of intra-hepatic bile duct and common bile duct,and showed “soft rattan sign”,7 lesions showed the expansion of the bile duct inside and outside the liver and the pancreatic duct,and “double duct sign”could be seen.2 cases showed the expansion of the com-mon bile duct.Conclusion The combination of non-enhanced MR and MRCP can show duodenal papilla adenocarcinoma with low biliary obstruction .Definite MRI diagnosis of duodenal papilla adenocarcinoma is important for treatment.

Objective To evaluate the apparent diffusion coefficient(ADC) value of mono-exponential diffusion weighted imaging(DWI) and the true diffusion coefficient(D) value, related diffusion coefficient(D*) value, perfusion fraction (f) value of bi-exponential model DWI in reflecting the expression of vascular endothelial growth factor (VEGF).Methods Using immunohistochemical staining method to detect VEGF expression in the 28 cases of gastric carcinoma tissue section and the surrounding normal gastric tissue.The differences of ADC value, D value, D* value, f value in different VEGF expression grading and gastric carcinoma classification were analyzed respectively.Results The differences of ADC value, D value, f value between different VEGF grading were statically significant,as the higher VEGF grading accompanied wth the lower ADC values, D value and the higher of f value;and the differences of the parameters between high and low differentiated gastric carcinoma were also statically significant (P<0.05).Conclusion The ADC value of mono-exponential DWI and the D value,f value of bi-exponential model DWI could evaluate the expression of VEGF and reflect the gastric carcinoma angiogenesis.

A three-dimensional finite element model of the maxillary canine was developed including periodontal ligament, pulp and alveolar bone. And the stress distributions in the periodontal tissue were obtained under different orthodontic force. The specific aims were to make the model by means of the more advanced and accurate twin CT, to provide more accurate data for clinical use, and to build a more accurate model for the simulation of maxillary canine movement under orthodontic forces.
Cuspid ; Dental Stress Analysis ; Finite Element Analysis ; Humans ; Maxilla ; Models, Biological ; Orthodontic Appliances ; Periodontal Ligament ; physiopathology ; Periodontium ; physiopathology ; Stress, Mechanical ; Tooth Movement Techniques

ObjectiveTo investigate the association of phosphorylation of mammalian target protein of rapamycin (pmTOR) expression with glioma malignancy grades,and the correlation of pmTOR expression with Survivin and Ki-67,which represent tumor cell anti-apoptosis ability and reproductive activity.MethodsImmunohistochemistry EliVision method was employed to detect the expression of pmTOR,Survivin and Ki-67 in paraffin tissues from 87 patients with glioma (grade Ⅰ - Ⅱ 27 cases,grade Ⅲ24 cases and grade Ⅳ 36 cases).The association between positive expression rate,level of pmTOR and malignancy grades,and the correlation of its expression level with Survivin and Ki-67 were further evaluated.Results There was no significant difference in the positive expression rate of pmTOR among grade Ⅰ - Ⅱ(77.8％,21/27),grade Ⅲ(75.0％,18/24) and grade Ⅳ (72.2％,23/36) (P ＞ 0.05).However,the significant association between pmTOR expression level and malignancy grades was observed.The expression from 87 patients with glioma was significantly positively correlated with Survivin and Ki-67 expression level (r =0.858,P ＜ 0.01 ;r =0.708,P ＜ 0.01 ).ConclusionsThe expression level of pmTOR is associated with malignancy grades,tumor cell anti-apoptosis ability and reproductive activity.pmTOR may be served as a useful marker for predicting the biological behavior of glioma and a useful target for gene therapy.

Objective To discuss MRI manifestations of overlap syndrome of autoimmune liver diseases and the diagnostic value of the MRI .Methods Seven patients of overlap syndrome of autoimmune liver diseases were recruited .The MRI examination (inclu‐ding T1WI ,T2WI ,DWI and MRCP )were underwent on these patients .MR features of overlap syndrome were reviewed by two ra‐diologists by consensus .Two radiologists independently reviewed the studies in a blinded fashion .Results AIH/PBC 4 cases ,AIH/PSC 1 case ,PBC/PSC 1 case ,AIH/PBC/PSC 1 case was collected .MRI of AIH/PBC has the MRI feature of AIH and PBC .MRI of AIH/PSC has the MRI feature of AIH and PSC .MRI of PBC/PSC has the MRI feature of PBC and PSC .MRI feature of AIH/PBC/PSC has the MRI feature of AIH ,PBC and PSC .Conclusion If the patients who sufferd autoimmune liver diseases displayed the MIR images of other autoimmune liver diseases ,the patients were considered that had developed into overlap syndrome of autoim‐mune liver diseases .

Objective To investigate the relationship between cerebral white matter fractional anisotropy(FA)and metabolite con-centrations measured by 1 H magnetic resonance spectroscopy(1 H-MRS)in healthy adults.Methods Diffusion tensor imaging(DTI) and 1 H-MRS were acquired from thirty-one healthy adults at 3.0 T MR system.The concentrations of N-acetylaspartate(NAA), choline(Cho),creatine(Cr),the ratios of NAA/Cr and FA values of DTI were measured in 353 voxels,covering the bilateral medium corona radiata.According to the age,all voxels were divided into two groups:the senior group (mean age=29 years),and the senior group(mean age=5 6 years).The correlations between FA values and age were analyzed using Pearson’s correlation coefficients.The correlations between FA values and metabolite concentrations were estimated using partial correlations test controlling for the age re-lated bias.Results Pearson’s correlation analysis revealed a negative correlation between FA values and age in 353 voxels(r=-0.146,P<0.05),senior group(r=-0.204,P<0.05)and senior group(r=-0.162,P<0.05).Only the correlation between NAA and FA values were significant(r=0.339,P<0.05;r=0.213,P<0.05;r=0.430,P<0.05).There were positive relation-ships between FA values and NAA/Cr among 353 voxels (r=0.166,P<0.05)and senior group(r=0.305,P<0.05).Conclusion There are correlations between cerebral white matter FA values and metabolite concentrations measured by 1 H-MRS .Combining 1 H-MRS with DTI can reveal the relationship between microscopic white matter integrity and metabolic characteristics of the white matter.

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.

Objective To investigate the utility value of monoexponential and biexponential DWI in the differential diagnosis between benign and malignant liver neoplasms.Methods Seventy three patients with pathologically or clinically confirmed liver mass,were analyzed retrospectively and categorized into benign and malignant groups between January 2013 and October 2013.Malignant group included 46 patients with 53 lesions,while 27 patients in benign group had 35 lesions.All patients underwent MR examinations on 3.0T system (GE 750).Conventional MR T1WI,T2WI,DWI(b=0,800 s/mm2) (to obtain ADC with monoexponential modeling),multi-b value DWI(b=0,20 50,100,200,400,600,800 and 1 200 s/mm2) (to obtain Slow-ADC,Fast-ADC,f with biexponential modeling) and dynamic enhancement were performed.The ADC,Slow-ADC,Fast-ADC and f mean values of benign and malignant liver neoplasms were measured and analyzed by using independent samples t test.Diagnostic efficacy of these parameters in malignant group was evaluated by using receiver operating characteristic curve,with histopathologic findings as the gold standard.Results ADC,Slow-ADC,Fast-ADC and f of malignant group were lower than those of benign group [ADC:(1.79±0.35)× 10-3 mm2/s vs (1.16±0.36) × 10-3 mm2/s; Slow-ADC:(1.67±0.25) × 10-3 mm2/s vs(0.94±0.22)×10-3mm2/s; Fast-ADC(72.40±23.70)×10-3mm2/s vs(34.62±17.43)×10-3mm2/s; and f:(33.59± 11.77)％ vs (22.28±8.97)％ in benign and malignant groups,respectively).Significant inter-group difference was observed in ADC,Fast-ADC,Slow-ADC and f (t=0.89,14.77,8.96 and 5.47,respectively and P＜0.05).The areas under the ROC curve (AUC) of ADC,Slow-ADC,Fast-ADC and fwere 0.938,0.974,0.895 and 0.789,respectively.The sensitivity and specificity of ADC,Slow-ADC,Fast-ADC and fwere 90.6％ (48/53),96.2％ (51/53),90.6％ (48/53) and 90.6％ (48/53) and 85.7％ (30/35),91.4％ (32/35),82.9％ (29/35) and 57.1％ (20/35)respectively for differentiating benign from malignant hepatic lesions.Conclusion ADC obtained with mono-exponential modeling and Fast-ADC,Slow-ADC,f obtained with biexponential modeling are useful parameters in distinguishing benign and malignant hepatic lesions,among which slow-ADC demonstrates the highest diagnostic efficacy.

OBJECTIVE:To systematically review the effect of ticagrelor versus prasugrel on platelet reactivity,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD and Wanfang Database,randomized con-trolled trials(RCT)about the effect of ticagrelor versus prasugrel on platelet reactivity were collected. Meta-analysis was performed by using Rev Man software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS:Totally 17 RCTs were enrolled,involv-ing 2 757 patients. Results of Meta-analysis showed,regardless of Verity Now(VN)detection method [MD=15.43,95%CI(-0.39, 31.25),P=0.06] or vasodilator stimulus phosphoprotein(VASP)detection method [MD=-3.04,95%CI(-8.98,2.90),P=0.32], ticagrelor and prasugrel had the same effects on platelet reactivity under loading dose,the differences were not statistically significant;regardless of VN detection method [MD=-48.94,95%CI(-58.04,-39.84),P<0.001] or VASP detection method [MD=-14.32, 95%CI(-20.45,-8.20),P<0.001],the effects of ticagrelor were better than prasugrel on platelet reactivity under maintenance dose,the differences were statistically significant. CONCLUSIONS:At the loading dose,there was no difference between ticagrelor and prasugrel,but ticagrelor has more benefits than prasugrel under maintenance dose.